COMMERCIAL. No. 34 (1883). RESPECTING THE CHOLERA EPIDEMIC IN EGYPT: Presented to both Houses of Parliament by Command of Her Majesty. LONDON; PRINTED BY HARRISON AND SONS. To be purchased, either directly or through any Bookseller, from any of the following Agents, via., Messrs. Hansard, 13, Great Queen Street, W. 0., and 32, Abingdon Street, Westminster ; lIUJBBI'B. iIAUOAHi;, ivj, VIXUJIL t^UCBU OKICVb, TT .\J. y (tUU (Jll, J"lUlllgUUll K3UTWU, TV CHI/IIUJINbUI , Messrs. Etee and Spottiswoode, East Harding Street, Fleet Street, and Sale Office, House of Lords; Messrs. Adam and Charles Black, of Edinburgh ; Messrs. Alexander Thorn and Co., or Messrs. Hodges, Figgis, and Co., of Dublin. [C— 3783.] Price Is. Id TABLE OP CONTENTS. No. Name. Date. Subject. P a S e 1 Consul Cookson .. .. June 27, 1883 Resolution by Quarantine Board to place Damietta in quarantine, in consequence of outbreak of cholera there. First Report thereon . . • • I 2 „ „ . . . . 29, Arrangements for allowing vessels to pass the Canal without contact with infected places. Report on nature of the disease . . • • • • * 8 To Sir E. Malet ? . . July 9, Her Majesty's Government wish to give every (Telegraphic) assistance to Egyptian Government in suppressing the cholera . . • • • • . . 10 4 Sir E. Malet .. .. 10, Thanks for offer in No. 3. Egyptian Government have taken all necessary steps. Disease is not spreading . . . • • • . . 10 5 To' Surgeon-General Hunter. 14, Instructs him to proceed to Egypt and report on the outbreak, and offer advice as to what should be done . . . . • •• _ . * * 6 To Sir E. Malet . . . . 14, Sends copy of No. 5, and explains position in which Surgeon-General Hunter is sent out . . 12 7 Consul Cookson . . . . 5, Memorandum by Mr. Mieville on origin of the disease ; it is endemic, and due to local causes . . 12 8 Sir E. Malet .. .. 16, Seven European doctors have been sent to 'the (Telegraphic) infected places . . . . . . . . 14 9 „ „ '. . . . 17, Cordons will be withdrawn in consequence of great (Telegraphic) number of places infected .. .. ..14 10 ? .. .. 18, Egyptian Government wish twelve doctors to be sent from England . . . • • l% 11 Consul Cookson .. .. 10, Measures taken at Damietta. Carcases of dead cattle still float in the Nile. Table of mortality. Measures taken by the Government generally . . 14 12 „ „ .. .. 10, Reports by Dr. Mackie on the state of Damietta and the nature of the disease. Probably of local origin. Criticism of measures adopted at Damietta. Dr. Flood's statement as to importation in " Timor " . . . . • • . . 20 13 To Sir E. Malet . . . . 19, Answer to No. 10. The doctors will be sent . . 24 (Telegraphic) 14 „ „ .. .. 21, Doctors attached to the British troops will give (Telegraphic) assistance pending arrival of doctors sent from England . .. .. •• ..24 15 „ „ . -? 21, If Egyptian Government wants Mahommedan (Telegraphic) doctors, request should be addressed direct to India .. .. •• •• 16 Sir E. Malet . . . . 21, Attention of Egyptian Government called to burial (Telegraphic) of dead cattle . . . . • • 24 17 „ „ .. .. 22, Formation of an Extraordinary Committee, which. will issue and execute measures for coping with the epidemic . . • • • • . . 25 18 To Sir E. Malet .. .. 24, Two doctors have already started ; the others leave (Telegraphic) as soon as possible . , « •. • ... • • 25 19 Consul Cookson .. .. 22, Formation of an Executive Committee at Alexandria, to improve the sanitary state of the town . . . . . • • • 25 20 Sir E. Malet .. .. 16, State of Mansourah. Great destitution, but probably no actual starvation. Difficulty of working the cordon. Tables of mortality . . ri 26 21 Consul Cookson . . . . 16, Alleged importation of the cholera by the " Timor " 22 Sir E. Malet . . . . 16, Names of European doctors at the infected places . 86 23 Dr. Mackie .. ? 17, Observations on the disease generally. Analysis of first cases at Alexandria. Story of importation by "Timor" disproved. Effect cf cordons as to spread of the disease . . . . . . 37 24 To Sir E. Malet . . . . 25, Are medicines required ? . . . . . . 40 (Telegraphic) 25 Sir E. Malet . . . . 25, The Khedive has inspected the hospitals . . 40 (Telegraphic) . . 26 To Sir E. Malet . . . . 26, Consult Surgeon-General Hunter as to obtaining hospital assistants from India, and press his advice on Egyptian Government . . . . 40 27 Sir E. Malet .. .. 25, Refers to No. 15. Egyptian Government does not (Telegraphic) require hospital assistants from India . . . 4C 28 Tq Sir E. Malet ? ? 26, The remaining ten doctors leave on July 26 40 (Telegraphic) No. I Name. Date. Subject. Pago 29 Sir E. Malet .. .. July 26, 1883 Prefect of Cairo is too hastily blamed. Colonel Chermside is working with him . . . . 4' 30 To Sir E. Malet . . . . 27, If mare doctors are wanted they should be asked (Telegraphic) for nt once . . . . . . 4 31 »» »i . i • . . 30, Further doctors can be sent if wanted. Does (Telegraphic) Egyptian Government still refuse Indian medical assistants ? . . . . . . 4 32 Sir E. Malet . . . . 30, Reply to No. 30. Forty hospital assistants and eight doctors wanted from India . . . . 41 33 ITo Sir E. Malet .. -.. - 80, For information as to alleged levying of a tax on the Inn ml of dead cattle .. . . .. 4 34 i Sir E. Malet .* .. 17, Report by President of Board of Health, alleging that the cholera was imported . . . . 4 35 „ „ .. .. 31, The Egyptian Government concurs in request reported in No. 82. Telegram sent to India in consequence . . . . . . 4« 36 To Sir E. Malet .. .. 31, Acknowledges receipt of No. 34. Wish to receive any further Report by President of Board . . 4 37 | Sir E. Malet .. .. 18, Incloses copy of correspondence respecting dispatch of medical assistance from England . . . . 4 „ H . . . . 22, Reports on the cholera at Mansourah. Defective burials. Fall in the death-rate . . . . 4( 39 I „ „ . . . . 22, Note from the Egyptian Government respecting manner of intermeut . . . . . . 4 40 To Sir E. Malet .. .. Aug. 1, Is the burial of cattle still subject to a tax ? .. 4 (Telegraphic) 41 Sir E. Malet .. .. 1, Replies to above. Tax abolished, and authorities (Telegraphic) warned not to levy it . . . . 49 42 Consul Cookson . . . . July 22, Preliminary Report by Doctors Ferrari and Chaffey on the outbreak at Damietta. Bad sanitary state of the town . . . . . . 49 43 „ „ . . . . 23, Table of mortality at Damietta from the 20th June to the 18th July .. .. .. ..52 44 jj »« • • • • 23, Letter from Dr. Flood maintaining that the cholera might have been imported by the "Timor:" statement contradicting this assertion by Governor of Port Said . . . . 6^ 45 Sir E. Malet . . . . 24, Letters from Dr. Mackie. Dr. Dutrieux's opinion that epidemic is of local origin. Hardship entailed by isolating houses and villages . . 5( 46 „ „ ? . . 24, Ministerial Resolution appointing Extraordinary Committee mentioned in No. 17 . . . . 58 47 „ „ . . . . 25, Note from Egyptian Government, declining offer of hospital assistants sent from India. . . . 5f 48 „ „ ? . . 26, Further letter from Dr. Flood maintaining that cholera may have been imported by "Timor." Analysis of first cases at Port Said. Despatch from Consul Burrell, showing that the epidemic could not have been imported by the " Timor " . 60 49 „„ . . . . Aug. 8, Surgeon-General Hunter is going on a tour of (Telegraphic) inspection in Lower Egypt . . . . 61 50 Mr. Cookson .. .. 11, Mode of interment. Riot at Alexandria. Order (Telegraphic) restored.. .. .. .. ..61 51 Sir E. Malet .. .. 3, Arrival of the doctors from England. Their distribution and position . . . . . . 6] 52 „ „ . . . . 5, Report on the epidemic at Cairo and on the state of the town. Tables of mortality .. ..62 58 „„ ? ? 6, Mortality Returns up to the 31st July. Details of mortality at Cairo up to the sth August. Observations on the facts shown . . . . . . 68 54 „„ . . . . 6, Effect of the cordon round Mansourah. Alleged scarcity of provisions caused by stoppage of the railway. Report by Committee formed at Mansourah blaming General Baker . . . . 71 55 „ „ . . . . 6, Reports on the outbreak at Zagazig and at Birketes-Sab .. .. .. .. ..79 56 „ „ . « . . 6, Letters of introduction furnished by Egyptian Government to the English doctors . . 81 57 „„ ? . . 6, Instructions issued to British Consular authorities in Cairo district on the outbreak becoming known . . . . . . . . 81 „ „ . . . . 6, Report on progress of the epidemic at Mansourah. Working of the cordon. Want of provisions . . 82 59 „ „ . . ... 6, Good effect of removing the population from certain quarters of Cairo . . . . 85 60 Consul Cookson ? . . 6, Report on the comparative freedom of Alexandria from cholera . . . . . . 85 61 „ „ .. .. 6, Average mortality throughout the country .. 86 iii No. Name. Date. Subject. Pago 62 Consul Cookson .. .. Aug. 6, 1883 Report by Drs. Ferrari and Chaffey on the origin of the outbreak at Damietta: sanitary condition of the town and district; nature and progress of the epidemic . . . . . . . . 87 63 To Sir E. Malet .. .. 17, Statements in No. 58 are satisfactory .. ..98 64 „ „ . . . . 17, Approves instructions in No. 57 . . . . 98 65 v it .. .. 17, Approves action reported in No. 35 .. ..98 66 », ;, . . • . 17, Receipt of despatches to No. 59. Thauks for complete information they contain . . . . 98 67 Sir E. Malet .. .. 7, Sends another copy of Report in No. 62. Observation on opinions expressed in it . . . . 09 iv 1883. No.l. Consul Coohson to Earl Granville, —(Received July 9.) My Lord, Alexandria, June 27, 1 883. I HAVE the honour to transmit herewith to your Lordship a despatch addressed to me by Mr. Mie*ville relative to the recent outbreak of cholera, at Damietta, I have, &c. (Signed) CHAS. A. COOKSON, Inclosure 1 in No. 1. Consul Mieville to Consul Coohson. (Extract.) Alexandria, June 27,1883. II HAVE the honour to report that an extraordinary meeting of the Quarantine ard was held on the 25th instant, to consider the news that had been received from mietta of the existence of cholera. It was resolved to place arrivals from Damietta in quarantine for seventeen days, ten of which to be performed at Ezbeh, the Damietta mouth of the Nile, about 9 miles from the town, and seven days at Mcx, near Alexandria. A further Resolution was passed giving expression to the hope that the Board of Health had, under the circumstances, taken special measures for the preservation of the rest of Egypt. I have the honour to transmit to you a copy of the preliminary Minute drawn up at Damietta by the Joint Medical Commission which was sent to examine on the spot into the origin and the exact nature of the epidemic. Inclosure 2 in No. 1. Proces- Verbal of the Medical Commissions. R NOTTS, Soussigne's, membres de la Commission Mixte charge'e de se rendre a iette pour y 6tudier la maladie gui s'y est manifesto ces jours derniers, apres nous reunis dans la dite locality et avoir examine 1 un assez grand nombre de malades s de'ce'de's, et avoir pratique" une autopsie, sommes unanimement d'opinion que les sympt6mes pre*sente"s par les malades que nous avons observes sont ceux dv cholera. Vu la marche rapide de la maladie, la forme presque foudroyante de quelques cas, le grand nombre dcs attaques, la proportion relativement £Lev6e dcs de"ces, rextension que prend la maladie dans la ville en dehors dv foyer primitif , nous sommes d'avis que cette affection pre"sente les caracteres d*un cholera e'pide'mique. ETout en reconnaissant a la maladie la forme Ipide'mique, nous devons dire qu'il nous a pas e^e* possible, malgre" nos recherches a cet e*gard, d'en determiner l'origine le specifier si elle a pris naissance sur place ou si elle a 6t6 imported. 11523] * * * B 2 Le present proces-verbal sommaire est dresse par la Commission en attendant la remise d'nn Rapport de'taille' qu'il a e*te* juge" ne"cessaire de re"diger collectivement au (Signe") Dr. FERRARI. Dr. ANNINOS. Dr. GRANT. Dr. ZAMBAKOS. Dr. ARDOUIN BET. Dr. WINKLER. Dr. HAMAI. Dr. CHAFFEY BEY. Dr. DACOROGNA BEY. Dr. HERRAOUI. Damiette, le 25 Juin, 1883. (Translation.) WE, the Undersigned, members of the Mixed Commission appointed to proceed to Damietta to inquire into the disease which has recently broken out there, after having met, and having examined a sufficient number of sick persons and dead bodies, and having made a post-mortem examination, are unanimously of opinion that the symptoms shown by the sick we examined are those of cholera. Considering the rapid spread of the illness, the nearly sudden deaths which it sometimes occasions, the great number of persons attacked, the large proportion of fatal cases, the area over which the disease has spread in the town beyond the original focus* are of opinion that the malady has the characteristics of epidemic cholera. While acknowledging that the disease is epidemic, we must confess to having been unable, notwithstanding our inquiries, to determine its origin or to specify whether it arose locally or was imported. This short proces-verbal is drawn up by the Committee pending the detailed Report which will be prepared at a meeting at Cairo. (Signed) Dr. FERRARI. Dr. ANNINOS. Dr. GRANT. Dr. ZAMBAKOS. Dr. ARDOUIN BEY. Dr. WINKLER. Dr. HAMAI. Db. CHAFFEY BEY. Db. DACOROGNA BEY. Dk. HERRAOUI. Damietta, June 25, 1883. No. 2. Consul Cookson to Earl Qranville. — {Received July 9.) My Lord, Alexandria, June 29, 1883. I HAVE the honour to transmit herewith to your Lordship a despatch addressed to me by Mr. MieVille, reporting the measures taken by the Sanitary Board for the regulation of the transit of vessels through the Suea Canal during such time as Egypt might be considered by Europe as infected. I have, &c (Signed) OHAS. A. OOOKSON. Inclosure 1 in No. 2. Consul Mieville to Consul Cookson. Sir, Alexandria, June 29, 1883. X continuation of my despatch of the 27th instant, I have the honour to herewith printed <*>pies of the Report of tin Joint Medical Commissions 3 my above-mentioned despatch. Khe Council held further extraordinary sittings on the 27th and 28th instant to. er the intricate question relative to the transit of vessels through the Suez Canal ; such time as Egypt may be considered by Europe as infected. As a preliminary measure, I proposed the immediate isolation of all pilots not hitherto compromised, so that vessels desirous of passing the Canal without communicating with Egypt might still take a " clean " pilot on board either at Suez or Port Said, and not be obliged to incur the great expense of employing a special pilot- Xt was further agreed that pilots already compromised should be specially affected service of vessels communicating with Port Said and vessels otherwise compro- These resolutions are, however, subject to modification, as such arrangements are necessarily dependent on the Canal authorities. A quarantine of seventeen days has been imposed here and in other Egyptian ports on arrivals from Port Said since cholera cases have been reported in that town. The inclosed letter addressed to me by the President of the Council treats of thi9 quarantine in detail. I have, &c. (Signed) W. F. MIIJVILLE, British Delegate. Inclosure 2 in No. 2. Rapport dcs Commissions Medicates charge'es de determiner la Nature et les Carctcteres de la Maladie gui a e elate a Damiette le 22 Jwn, 1883. NOUS, Soussignes : Membres de la Commission de*le"gue"e par le Conseil de Sant6 et d'Hygiene Publique > :— Dr. Dacorogna Bey, Vice-President dv Conseil de Sante* ; Dr. Ahmet Bey Hamdi, Inspecteur Sanitaire dv Caire ; Dr. Abdel Rahman Bey Herraoui, Professeur a l'ficole de Me"decine ; Dr. Grant Bey, Me"deein-en-chef dcs Chemins de Fer. Membres de la Commission de*le*guee par le Conseil Sanitaire Maritime et Quarantenaire : — Dr. Ardouin Bey, Inspecteur-Ge"ne*ral dv Service Sanitaire Maritime et Quarantenaire ; Dr. Anninos, Dele'gue' de Grece au Conseil Sanitaire Maritime et Quarantenaire; Dr. Ahmet Bey Chaffey, Dengue* %yptien a Djeddah ; Dr. Ferrari, Directeur de l'Office Quarantenaire a Damiette. ¦Nous sommes rendus a Damiette le 24 Juin, 1883, afin d'e*tudier la maladie gui it d'apparaltre dans cette ville et de determiner sa nature. Arrives sur les lieux nous avons tout dabord recherche* le chiffre de la population de Damiette. Nous avons e"galement e"tabli pour les comparer les chimes de la mortality en temps normal et depuis l'apparition de la maladie en question. Nous donnons dans le Tableau suivant le re"sultat de nos recherches :— Population de Damiette, environ 35,000. Tableau Comparatif de la Mortality ge*nerale pendant la Sexnaine dv 19 au 26 Juin, en 1882 et en 1883. 1882. 1883. luin 19 .. .. .. 3 6 » 20 „ .. 2 4 O I ¦ ¦ "if 99 <"* •• •• •• 1 I 99 Q ' 1 A 99 ¦***' • • • • * • O 17 „ 23 .. .. .. 2 23 ,» 24 .. .. .. 7 25 j» 25 .. .... 3 24 ("15231 2 4 "1? Nous avons voulu ensuite nous renseigner sur les conditions atmospnenques ac ia locality pendant les journees gui ont precede" l'explosion de la maladie et avons appris que pendant trois jours, dv 19 au 21 Juin, il y a eu une eleVation notable de la temperature avec absence de vent. . . s A la m6me e*poque la f6te annuelle dv Mouled de Cheik el Chateb, reunissait a Damiette environ 16,000 personnes venues de diff^rents points de 1 Egypte. II requite e"galement dcs informations gui nous ont e"te* f ournies, notamment par le Gouverneur et le me"decin de la locality, que c'est le 22 Juin que Ton a constate une augmentation dans le nombre dcs malades et dans celui dcs de*ces, gui n'ont fait qu ? augmenter a partir de cette date. Les recherches auxquelles nous nous sommes livre's ont confirme* ces informations. , 1 Pendant les deux ou trois premiers jours la maladie sest manifestee dans 1 quartier situe" pres dv fleuve et le long dv Kalig ; elle est ensuite sortie de ses limites c s'est e"tendue sur plusieurs points de la ville. Inde"pendamment de sa situation particuliere entre le Nil d une part, les l^acs Menzaleh de Tautre, sur un terrain bas et humide a proximity de rivieres, Damiette s trouve dans de mauvaises conditions hygteniques. La ville est traversed par un nalij dans lequel se deVersent les e*gouts dcs Mosque*es et dcs -uaisons riverames c dont l'eau, malgre* cela, sert a la consommation dune pai ;e ; e de la population Plusieurs latrines a fosses d^couvertes, notamment pres dcs JViosqu^es, repandent dcs emanations malsaines. D'apres les renseignements gui nous ont etc donnes par dcs personnes dignes de foi, un grand nombre d'animaux morts, chanes par le fleuve, viennent s'arreter aux environs de la ville. De la viande provenant d'animaux morts dv typhus bovin serait journellement et clandestinement fourme a bas prix a la consommation publique. Nous ajouterons que l'alimentation dcs habitants de Damiette est mauvaise ; ils se nourissent principalement de poissons sales appele*s •' fessihs.'* Examen dcs Malades. 1 . — Dans la Soiree dv 24 Juin. Les membres de la Commission dv Caire ont examine* :— let 2. Dans une meme maison deux hommes adultes, a peu pres dv m&neage de 30 a 35 ans. Le premier, malade depuis deux jours, pre"sente les symptdme suivants: — . c . x Les extre"mite"s sont froides, le tronc est encore chaud, la peau est nd6e, le tacie est chole'rique, la voix est ; il y a absence presque complete de pouls. L malade aeu dcs vomissements, de la diarrhee, et dcs crampes. Ces derniers accidents ont actuellement disparu. Le second malade examine presente dcs sympt6mes nous paraissant se rattacner une fievre rhumatismale. E-ien de suspect. * * -n 3. Dans le meme quartier, un jeune homme de 18 ans appartenant a une famill ais^e, dont le pere a succomb^ dans la journe"e a dcs accidents suspects, arrive" le matin de Mansurah, est pris a son tour de la maladie. Les extre*mite"s ne sont pas tout afai froidesi la langue est rouge et seche. II y a dcs vomissements, de la diarrn6 blanchatre, dcs gargouillements abdominaux. 4. Un homme de 50 ans malade depuis le matin, atteint de diarrhee et de flevre langue charged, pouls fort, tete lourde, ne nous parait pas presenter dcs symptdme suspects bien caracte"rises. . 5. Un jeune homme de 30 ans appartenant a la classe aise"e a 6t6 pris dan la matinee de vomissements, de diarrhe*e, et de crampes. Au moment de notr visite, 10 heures dv soir, le refroidissement est general, la peau est ridee, le extremit^s un peu cyanos^es, les globes oculaires sont enfonce"s, les pupille dilatees et fixes ; aphonie, e*tat de collapsus, Cc malade est mort a 3 heures et demi dv matin. 2.— Dans la Journie dv 25 Juin* Les membres dcs deux Commissions Me*dicales re"unies ont proce'de' a Texamen dcs malades suivants : — , ? 6. Ali Youssen, age" de 45 ans, est tombe" malade la veille, au coucher dv soleil. Eefroidissement complet de tout le corps, de la langue, peu ride"c et cyanose*e, commencement de collapsus, yeux enf onces et entoure"s dun cercle bleuatre, voix crampes, vomissements, diarrhe*e abondante aqueuse, avec dcs muquosites blanchatres, 5 7. Une jeune femme de 18 ans souffre depuis un mois de fievre mtermittente, cc gui ne la pas empeche'e de se livrer a ses occupations habituelles jusqu'au 24, epoque a laquelle l'aphonie et le refroidissement ge"ne*ral se sont de*clare*s tout a coup. Pas de vomissements, peu de diarrhe'e, l'amaigrissement nest pas prononce*, les yeux sont enfonce's dans les orbites, la peau est ride'e, cyanose'e. II y a contractures dcs doigts, collapsus. Nous avons appris que la malade est morte dans la 8. Nous nous sommes fait conduire chez une ne*gresse age*e de 25 ans, malade depuis le 23 et ayant eu dcs vomissements, de la diarrhee aqueuge, de Panurie. Nous l'avons trouve"e morte. Bans le courant de la journe'e nous avons proce'de' a Tautopsie de son cadavre. 9. Un enfant de sexe masculin, age" de 6 ans, malade depuis hier soir, mort a 6 lieures dv matin, a pre'sente' les phe*nomenes suivants : vomissements, diarrhe'e aqueuse, refroidissements de tout le corps. Nous constatons que le cadavre est cyanose*. 10. Ibrahim Mallaoui, age* de 50 ans, appartenant a la basse classe, malade depuis liier a midi. Le corps est emacie*, les extre^mite's sont froides, la peau est ride'e, les yeux excaves entoures dun cercle bleuatre, voix e*teinte, crampes, vomissements, diarrhe'e aqueuse avec muquosite's, peu d'urine. 11 et 12. Deux femmes habitant la meme maison. L'une age*e de 25 ans est malade depuis trois jours, son corps est froid, les extre'mite's sont un peu cyanose'es, langue tres froide, yeux excaves, voix e'teinte, ventre r^tracte*, vomissements, diarrhee aqueuse, anurie, crampes. t La deuxieme, agee de 30 ans, est malade depuis hier : refroidissement general, yeux enfonce*s dans les orbites, aphonie, vomissements, diarrhee. 13. Un homme de 20 ans, mort apres trois jours de maladie, aeu dcs vomissements, de la diarrhe'e, dcs crampes. 14. En nous rendant a I'h6pital, nous avons rencontre* sur une place publique un enfant de 12 a 14 ans, soutenu par un homme et gui venait d'etre pris subitement de vomissements aqueux blanchatres, de maux de tete, de douleurs et de de'faillances dans les extre'mite's. Cette attaque avait un aspect caracte*ristique. Plusieurs autres malades pre"sentant dcs sympt6mes semblables a ceux que nous avons pre*ce*deniment decrits, ont aussi 6te vus par divers membres de la Commission. Autopsie de la Femme gui fait V observation No. 8. Aspect exterieur dv Corps. tPeu d'e*maciation, la rigidite cadave*rique existe, la peau est ride'e, il y a un peu de ntracture dcs membres, les yeux sont enfonce"s dans les orbites. Ouverture du- Cadavre. ILe gros intestin est dans toute son etendue vide et re'tracte' ; il pre'sente l'aspect un cordon. L'intestin grele est congestionn^ et rempli dun liquide blanchatre, Mgerement colore* par extravasations sanguines. II ny a aucune alteration dcs glandes et follicules. L'estomac f ortement distendu est rempli dun liquide clair comme de l'eau ; la vessie est tout a. fait vide et re'tracte'e. La rate et le foie sont tres legerement congestionne's. Les reins sont dans un etat normal. Les poumons un peu congestionnes. II existe dcs adhe"rences anciennes de la plevre dcs deux c6te*s. ILe coeur presente une congestion veineuse, ses cavite*s sont remplies dun sang guide et noiratre. Les m^ninges pr^sentent une vascularisation arborescente de'veloppe'e, la surface dv cerveau et dv cervelet est fortement congestionn^e. II existe dans les ventricules un e"panchement sereux clair, prononc^. En resume, chez le plus grand nombre dcs malades que nous avons observes, les 6 et rapide dcs extre'mite's, la cyanose, souvent l'anurie, l'aphonie, ou tout au moms l'alt^ration de la voix, et un habitus, un facies caracteristiques. I En presence de cc tableau symptomatologique si frappant, les membres dcs deux imissions Me*dicales r&inies, apres mure discussion et examen dcs sympt6mes gui Taient 6tre communs au cholera, a la fievre pernieieuse algide, a la meningite e"mique, au typhus, et au catarrhe gastro-intestinal saisonnier, sont unanimes 3onnaltre que la maladie se"vissant a Damiette est bien le cholera. En outre, la ainete* de I 'invasion en g6ne"ral, la marche rapide de la maladie, la forme presque royante dans plusieurs cas, le grand nombre dcs attaques, la proportion relativefc e'leve'e dcs de"ces, l'extension que prend la maladie en dehors dv foyer primitif, et it qu'elle atteint indistinctement dcs individus d'age, de sexe, et de conditions les diffeVents, les amene a conclure qu'il s'agit dun cholera e'pide'mique. L'£pide*mie chole'rique actuelle pr^sente dans ses manifestations les particularity's suirantes : soudainete" et violence de l'attaque, absence de diarrh^e pre'monitoire dans la gene'ralite' dcs cas, dure"e de la maladie ordinairement courte et terminaison fre'quemment fatale. La Commission, malgr^ l'existence dcs mauvaises conditions hygi^niques e"noncees plus haut, et tout en reconnaissant qu'elles sont favorables au deVeloppement dune e'pide^mie, conside'rant que l'apparition dv cholera dans une contr^e ou ll n'existe pas ende'miquement, laisse supposer qu'il y a 6t6 imports, a voulu remonter a l'origine de la maladie se*vissant actuellemenfc a Damiette. Dans cc but elle a recherche si les premiers sujets atteints appartenaient a la locality meme, s'ils en etaient sortis avant d'etre malades, s'ils avaient eu dcs rapports avec dcs personnes ou dcs choses venant dv dehors. La Commission n'ayant pu recueillir aucune indication precise ace sujet, et manquant dcs donn^es sumsantes, se trouve dans l'impossibilite d'e"tablir la genese dv cholera e'pide'mique de Damiette. La Commission, avant de quitter Damiette, a cru devoir re"diger, pour les me'decins et les autorite's de la locality, une s^rie d'instructions relatives a la salubrity de la ville et a l'hygiene de ses habitants. (Signe") Dr. DACOROGNA BEY. Dr. ARDOUIN BEY. Dr. CHAEFEY BEY. Dr. GRANT BEY. Dr. A. HERRAOUI BEY. Dr. L. ANNINOS. Dr. AHMET BEY HAMDI. Dr. FERRARI. Caire, le 26 Mn, 1883. (Translation.) Report by the Medical Committees appointed to ascertain the Nature and Characteristics of the Disease which broke out at Damietta on June 22, 1»83. WE, the Undersigned : Members of the Committee appointed by the Council of Public Health and Hygiene : — Dr. Dacorogna Bey, Vice-President of the Council of Health ; Dr. Ahmet Bey Hamdi, Sanitary Inspector of Cairo ; Dr. Abdel Rahman Bey Herraoui, Professor at the School of Medicine ; Dr. Grant Bey, Chief Medical Officer to the Railways. Members of the Committee appointed by the Maritime Sanitary and Quarantine Board : — Dr. Ardouin Bey, Inspector-General of the Maritime Sanitary and Quarantine Service ; Dr. Anninos, Hellenic Delegate to the Maritime Sanitary and Quarantine Board; Dr. Ahmet Bey Chaffey, Egyptian Delegate at Djeddah ; Dr. Ferrari, Director of the Quarantine Offictf at Damietta. "We proceeded to Damietta on the 20th Junty, 1883, to inquire into the disease which had appeared in that town, and to ascertain its nature. On arrival we made inquiries as to the amount of population at Damietta. We also made a comparison between the normal death-rate and that since the outbreak in question. We subjoin the result of these inquiries :— - 7 Population of Damietta, about 35,000. TABfcE of the general Death-rate of the Week of the 19th to 26th June In 1882, compared with the same Week in 1883. 1882. 1883. June 19 .... .. 3 6 „ 20 .. .. 2 4 „ 21 .. .... 1 1 „ 22 .. .. .. 3 14 „ 23 .. .. 2 23 ? 24 7 25 „ 25 .. .. 3 24 ¦We then sought information as to the atmospheric condition of the place during lays preceding the appearance of the disease, and found that during the three , 19th to 21st June, there was a marked rise in the temperature and no wind. ¦At the same time the yearly feast of the Mouled of Sheikh el Chateb brought to ietta, from various parts of Egypt, some 15,000 persons. E\ further appears from what we learnt from the Governor and doctor of the that an increase in the number of sick cases and of deaths was noticed on the June ; the number has since then gone on increasing. Our own investigations ned this information. ¦For the first two or three days the disease showed itself in the quarter near the and along the Kalig ; it afterwards overstepped these limits and spread to several i of the town. Apart from its lying between the Nile and the lakes of Menzaleh, low damp soil near rivers, Damietta is in a bad hygienic state. The town is traversed by a' halig, which receives the contents of the drains of the mosques, and the houses on its banks, and the water of which is, nevertheless, used as drinking-water by a part of the population. Many latrines and open drains, especially near the mosques, give out unwholesome gases. Persons worthy of belief told us that a great many dead animals are brought down by the river and deposited near the town. The meat of animals that have died of bovine typhus appears to be clandestinely offered for sale at a very cheap rate, and this every day. ¦We must add that the food of the inhabitants of Damietta is bad ; it consists dpally of salt fish called " fessihs." Examination of Cases. I . — The Evening of June 24. The members of the Cairo Committee have examined :— BL and 2. Two adult men of about the same age, 30 to 35, living in the same i. The first has been ill for two days, and presents the following symptoms : — Extremities cold, trunk still warm, skin furrowed, face choleric, voice scarcely le, pulse almost entirely absent. Has had vomitings, diarrhoea and cramps. i latter symptoms have now disappeared. second presents symptoms which appear to us to belong rather io rheumatic er. Nothing suspicious. y. In the same quarter, a young man of 18, belonging to a tolerably well-to-do f § whose father had died during the day with suspicious symptoms ; he arrived morning from Mansurah and caught the disease. Extremities not quite cold, c red and dry. Vomitings, whitish diarrhoea, rumblings in his stomach. 4. A man of 50, taken ill in the morning with diarrhoea and fever. Tongue loaded, pulse strong, head heavy. Does not appear to us to present any well-defined suspicious symptoms. 5. A young man of 30, belonging to the tolerably well-to-do class, attacked in the morning with vomitings, diarrhoea and cramp. When we saw him, at 10 o'clock at night, low temperature was general, skin furrowed, extremities showed slight cyanosis, eye-balls sunk, pupils dilated and fixed, aphony, collapse. Died at 3.30 a.m. 8 2.-— On June 25. ¦The members of the united Medical Committees examined the following cases ' her: --_ _ IT"; J T. 16. Ali Youssen, 45, taken ill the day before at sunset. Whole of the body cold; so the tongue ; skin furrowed and attacked by cyanosis, collapse begun, eyes sunk surrounded by a bluish circle, voice scarcely audible, cramps, vomitings, abundant sry diarrhoea, with whitish mucus ; no urine. R7. A young woman of 18; has suffered for a month from intermittent fever, sh did not prevent her following her usual occupation until the 24th, when she suddenly seized with aphony and coldness of the whole body. No vomiting, but ) diarrhoea, wasting not marked, eye-balls sunk in the orbits, skin furrowed, osis, contraction of the fingers, collapse. We heard that she died in the night of K\. We had ourselves taken to the house of a negress of 25, ill since the 23rd; had omitings, watery diarrhoea and suppression of urine. We found her dead. During ly we performed a post-mortem examination. B). A male child of 6 ; taken ill yesterday evening, died at 6 a.m. with the ring symptoms ; vomitings, watery diarrhoea, whole body cold. Cyanosis visible c body. RIO. Ibrahim Mallaoui, 50 years old, belonging to the lower class ; ill since noon rday. Body emaciated, extremities cold, skin furrowed, eyes hollow, surrounded bluish circle, voice scarcely audible, cramps, vomitings, watery diarrhoea with is, but little urine. Lll & 12. Two women living in the same house. One, aged 25, ill for three days; y cold, slight cyanosis cf the extremities, tongue very cold, eyes hollow, voice scarcely audible, belly sunk, vomitings, watery diarrhoea, suppression of urine, cramps. The other, aged 30, taken ill yesterday ; whole body cold, eyes sunk in the orbits, aphony, vomitings, diarrhoea. 13. A man of 20 ; died after three days illness. Vomitings, diarrhoea, cramps. 14. Going to the hospital, we met on one of the public squares a child of from 12 to 14 held up by a man. It had been attacked suddenly with whitish watery vomitings, headache, pain and weakness of the extremities. This attack had a characteristic aspect. Several other cases, with symptoms similar to the preceding, were seen by various members of the Committee. Post-mortem examination of the Woman mentioned under No. 8* Aspect of the outside of the Body. But little emaciation, rigor mortis, furrowed skin, limbs but slightly contracted, eyes sunk in the orbits. Examination of the inside of the Body. The large intestine is throughout empty and contracted ; it looks like a cord. The small intestine is congested, and filled with a whitish liquid, slightly coloured by extravased blood. The glands and follicles are normal. The stomach is much distended, and is full of a clear liquid like water; the bladder is quite empty, and contracted. The spleen and liver are slightly congested ; the kidneys are normal. The lungs are slightly congested. There are old lesions of the pleura on both sides. The heart shows venous congestion ; the cavities are full of black liquidjblood.l The meninges show an advanced arborescent vascularisation ; the surface of the brain and of the cerebellum is much congested. In the ventricles there is a very marked clear serous effusion. | To sum up, the following are the predominant symptoms in the greater number of sick cases we observed : — Vomitings, watery diarrhoea, cramps, marked and rapidly developed coldness ox the extremities, cyanosis, suppression of urine, aphony, or at least a change in the voice, a characteristic appearance of the body and face. 9 after full discussion and examination of the symptoms which might he common to cholera, pernicious algid fever, epidemic meningitis, and to periodic gastro-intestinal catarrh, unanimously agree that the disease raging at Damietta is indeed cholera. Moreover, the general suddenness of the advent of the malady, its rapid spread, the many cases of almost sudden death it produces, the great number of attacks, the relatively high death-rate, the spread of the disease beyond its place of origin, and the B,ct that it attacks persons of all ages, sex, and class indifferently, leads them to conude that it is epidemic cholera. The present cholera epidemic shows the following particularities : — Suddenness and violence of the attack, absence of premonitory diarrhoea in most cases, generally short duration of the illness, and frequency of fatal termination. The Committee, notwithstanding the bad sanitary state of the town mentioned above, while recognizing that it is favourable to the development of an epidemic, considering that the appearance of cholera in a country where it did not exist endemically presupposes importation, tried to ascertain the origin of the malady now raging a Damietta. They therefore inquired whether the first cases were persons belonging to the place, whether they had left it before being attacked, and whether they had been in communication with persons or things coming from outside. The Committee having failed to elicit anything precise on this head as sufficient data are wanting, is unable to pronounce on the origin of the cholera epidemic at Damietta. Before leaving Damietta the Commission thought it well to draw up, for the use of the doctors and authorities of that place, a series of instructions relating to the health of the town and the hygiene of its inhabitants. (Signed) Dr. DACOROGNA BEY. Dr. ARDOUIN BEY. Dr. CHAJETEY BEY. Dr. GRANT BEY. Dr. A. HERRAOUI BEY. Dr. L. ANNINOS. Dr. AHMET BEY HAMDI. Dr. FERRARI. Cairo, June 26, 1883. Inclosure 3 in No. 2. Dr. Hassan to Consul Mieville. M. le De'le'gue, Alexandrie, le 28 Juin, 1883. IJ'AI l'honneur de vous informer qua la suite dcs nouvelles recues sur l'etat nitaire de Port- Said, le Conseil Sanitaire Maritime et Quarantenaire dans sa seance d'hier a decide quo les navires gui auront communique avec Port-Said passeront lc Canal en c"tat de quarantaine. I Si ces navires veulent communiquer avec Suez ils subiront une quarantaine de -sept jours aux Sources de Moise avec desinfection. Les marchandises a destination d'Egypte devront etre debarquees et desinfectees, celles a destination etrangere resteront a bord et les scelles seront apposes sur les cales. Une annotation sera mise sur la patente. Les navires ayant communique avec Port- Said arrivant a Kantarah et Ismailieh seront repousses a Suez. Les navires arrivant dans les ports figyptiens de la Mcr Rouge et provenant de Port-Said seront repousses a Suez. Si un cas suspect venait a se declarer soit dans la traversee entre Port-Said et Suez, soit pendant la quarantaine aux Sources de Moise, les navires, les passagers, et les marchandises a destination de l'Egypte seront envoyes a Tor pour y subir la quarantaine de dix-sept jours, et la desinfection re"glementaire. Les marchandises a destination de l'etranger resteront a bord et les scelles seront apposes sur les cales. Une annotation sera mise sur la patente. Les navires n'ayant pas communique avec Port-Said seront admis en libre pratique K;s pilotes se trouvant aujourd'hui en libre pratique seront completement isole"s Port-Said qua Suez pour s'embarquer sur les navires en libre pratique transitant il. ("15231 C 10 tes pilotes compromis pour avoir communique avec Port-Said ou pour s'e'tre embarque's sur dcs navires ayant communique avec cette ville, seront isol^s h Suez sur un navire ou dans un local special. Un remorqueur en c"tat de quarantaine les ramenera a Port-Said pour etre a raeme de conduire constamment les navires compromis. Veuillez, &c. Le President, (Signe*) Dr. HASSAN. (Translation.) Sir, Alexandria, June 28, 1 883. II HAVE the honour to inform you that, owing to the news which has been ved as to the sanitary condition of Port Said, the Maritime Sanitary and Quaran- Board decided at its sitting yesterday that ships which have touched at Port Said Id pass through the Canal in quarantine. ¦If such ships wish to touch at Suez, they shall undergo seventeen days' quarantine oses' "Wells and be disinfected. ¦Goods for Egypt will be unloaded and disinfected ; goods for foreign ports will in on board, and the hatches will be sealed. A note will be made on the bill of h. Ships which reach Kantarah and Ismailieh after having touched at Port Said will be repulsed at Suez. Ships coming from Port Said and reaching the Egyptian ports on the Red Sea will be repulsed at Suez. If a suspicious case should arise either during the journey between Port Said and Suez, or during the quarantine at Moses' "Wells, the ships, passengers, and goods intended for Egypt will be sent to Tor, to undergo quarantine for seventeen days and to be properly disinfected. Goods intended for foreign ports will remain on board, and the hatches will be sealed. A note will be made on the bill of health. Ships which have not touched at Port Said will be admitted to free pratique at Suez. The pilots who are now in free pratique will be completely isolated both at Port Said and at Suez, so that they may go on board the ships in free pratique passing through the Canal. The pilots who are compromised owing to their having landed at Port Said, or having gone on board ships which have touched at that town, will be isolated at Suez in a ship or in some place set apart for the purpose. A tug in quarantine will bring them back to Port Said, so that they may be able to pilot compromised ships. I have, &c. (Signed) Dr. HASSAN, President. No. 3. Earl Granville to Sir E. Malet. (Telegraphic.) Foreign Office, July 9, 1883, 5 p.m. HER Majesty's Government desire to help the Egyptian Government in carrying out any measures rendered necessary by the outbreak of cholera. Inform Ch^rif Pasha of this, and ask what is required. No. 4. Sir E. Malet to Earl Granville. — (Received by telegraph, July 10.) My Lord, Cairo, July 10, 1883. CIIERIE PASHA has sent me the inclosed message in reply to your Lordship's telegram of yesterday, and I have lost no time in forwarding its substance to you by telegraph. The Egyptian Government, whilst thanking Her Majesty's Government 11 lor XXiGXT ivXUd OH6l*« CIO 3 1 0 L I C/C L V> j IOXXISCx V OS ILL WctTlv OI cISSJ.SLcIHC/6« tio XI IO OllwlC^icl/ epidemic appears to be already on the decrease. I have, &c. (Signed) EDWARD B. MALET. Inclosure in No. 4. Cherif Pasha to Sir E. Malet. (Tetegraphique.) Alemndrie, le 10 Juillet, 1888. IREMERCIER le Gouvernernent de Sa Majesty pour son off re obligeant. Nous s pris toutes les mesures necessities par les circonstances, et nous avons meme [6 d'engager dcs me'decins non employes dv Gouvernement pour les envoy er sur eux. Nous n'h^siterions pas a faire appel a l'aide dv Gouvernement de Sa Majeste ipide^mie n'^tait pas d£ja en d^croissance, et si elle ne semblait pas devoir se iser. (Translation.) (Telegraphic.) Alexandria, July 10, 1883. E THANK Her Majesty's Government for their kind offer. We have taken all the sures rendered necessary by the circumstances, and have even decided to engage ors who are not employed by the Government in order to send them to the place, should not hesitate to appeal to Her Majesty's Government for help it" the 3mic was not lessening, and if it did not seem that it was going to localize itself. No. 5. i Earl Granville to Surgeon' General Hunter. Sir, Foreign Office, July 14, 1883. I HAVE to acquaint you that, in consequence of the present prevalence of cholera in Egypt, Her Majesty's Government have decided to send to that country a British medical officer for the purpose of investigating and reporting as to the origin of that disease and the best means for its repression. In selecting you as the officer best qualified for the purpose of carrying out the above objects, Her Majesty's Government have been guided by their knowledge of your distinguished general and medical attainments and of your special experience of Oriental I have therefore to request that you will make arrangements for immediately proceeding to Egypt, where, on your arrival, you will at once place yourself in communication with Sir E. Malet, Her Majesty's Agent and Consul-General. You will report to this Office, for the information of the Sanitary Department of the Local Government Board, what, in your opinion, is the origin and character of the disease now prevalent in Egypt, and the methods which, in your opinion, should be adopted to prevent the recurrence of it and its possible spread to this country. You will also give to Sir E. Malet the benefit of your experience and knowledge in advising the Egyptian Government as to the measures which should be immediately taken during the continuance of the disease ; and should the Egyptian Government, which has been informed of your arrival, desire to employ your services in organizing and directing measures for coping with the present outbreak or otherwise, you will give your best assistance to them in suggesting and carrying out the necessary measures. So far as their other duties permit, Mr. Consul Mieville, temporarily acting as British Vice-Consul at Alexandria and as Delegate to the International Quarantine Board in Egypt, and Dr. Mackie (Second British Delegate at that Board), are attached to your mission ; and Sir E. Malet has been requested to afford you the necessary clerical assistance. Mr. Cookson, Her Majesty's Consul at Alexandria, has also been informed of your arrival. I am, &c. (Signed) GRANVILLE. [1523] 12 No. 6. Earl Granville to Sir E. Malet.* Sir, Foreign Office, July 14, 1883. iHER, Majesty's Government have had under their consideration your telegram of the i instant, in which you report the result of your communication with Cherif Pasha ecting the supply of medical assistance in Egypt at the present time ; and I have now istruct you to inform his Excellency that while they are glad to learn the measures n by the Egyptian Government with a view to the suppression of the cholera they Id wish to know whether European medical men have been sent to the scene of the reak, as they consider that it is of vast importance that the services of persons of great and experience with respect to this disease should be secured. II have to inform you that Surgeon-General Hunter, a medical officer of great Indian rience, is being sent to Egypt. He will leave on the 20th instant. The object of his ion is to report as to the character of the disease now prevalent, and to advise you her there are any additional measures which you should urge the Egyptian Governt to take. I You will inform Cherif Pasha that Dr. Hunter's services are at the disposal of the iian Government, and you will recommend him to make use of them ; adding that, the character and knowledge of that gentlemau, Her Majesty's Government have ¦ confidence that those services will be of great benefit at the present juncture. For your further information and guidance in this matter, I inclose a copy of a letterf which I have addressed to Dr. Hunter, notifying his appointment in the above-mentioned capacity, and furnishing him with the necessary instructions. I have further to request that, as far as other duties may permit, Mr. Mieville and Dr. Mackie shall be attached to Dr. Hunter, and that you will make the necessary communications to them to this effect. You will also afford Dr. Hunter such clerical assistance as he may require, so that his own time may be devoted to devising the necessary measures for coping with the disease. I am, &c. (Signed) GRANVILLE. No. 7. Consul Cookson to Earl Granville.* — (Received July 16.) My Lord, Alexandria, July 5, 1883. I HAVE the honour to transmit herewith a despatch from Mr. Mieville, inclosing a Memorandum on the origin of the outbreak of cholera at Damietta, in which I entirely concur. I have, &c. (Signed) CHAS. A. COOKSON. Inclosure 1 in No. 7. Consul Mieville to Consul Cookson Sir, Alexandria, July 4, 1883. I HAVE the honour to forward herewith a Memorandum on the origin of the recent outbreak of cholera at Damietta. I have, &c. (Signed) W. F. MJEVILLE, British Sanitary Delegate. 13 Inclosure 2 in No. 7. Memorandum by Consul Mie'ville on the Origin of the Outbreak of Cholera at Damietta. IPHE news from Damietta did not assume definite shape, or at least was not fully mcd, until Sunday, the 24th June, on which day Committees of medical men left Alexandria and Cairo in order to ascertain on the spot the origin and exact nature c outbreak. The two Delegations joined at Damietta, and after a stay in the town 5S than eighteen hours they came away, and reported that the disease was epidemic ra, but that they were unable to say whether or no it had been imported. IPo show how the disease originated seems in these circumstances very difficult, but, careful consideration, I submit that it is sufficiently clear that the outbreak is due Jy to local causes, and that it could not have been imported. The broad facts which lead me to this conclusion are, that for months past reporl from the districts of Damietta and Mansourah have pointed plainly to the inference tha should sanitary measures be not promptly taken, some dire calamity must, sooner or latei befall the population. Bovine typhus was devastating the district, though the native denied all knowledge of it, and endeavoured to hide its very existence by having th animals slaughtered as soon as attacked, the tainted meat being sold for food, and th skins disposed of only too readily to clandestine dealers, who store them until favourabl opportunity offers for their export. Animals dying before they could be killed were thrown by scores into the neares canals, sometimes literally blocking the water-way, and these canals have all a commoi outlet — the Nile ; and at Damietta, situated as it is on a semi-circular bend of the river many of the carcases were caught in the reeds near the banks and left to putrefy in th sun and send off poisonous exhalations. The town itself, also, inhabited by some 34,00( souls, is poorly built, almost totally un-Europeanized, and always in a wretchedly bac sanitary condition. Again, at the time of the outbreak there was a great fair being held in the town, called the Fair of Sidi Shattar, and, with a population already poisoned by living to a great extent during the previous three months on diseased meat, and having only tainted water to drink, I hold that it needed but this unusual agglomeration of persons to cause the calamitous sickness. On the other hand, we have strong presumptive evidence that the disease could no possibly have been imported. The nearest place known to be infected with cholera wa Bombay, and we are assurer on high medical authority that there it was not of a epidemic character. The weekly mortality from cholera in that city rose, it is true, i the beginning of May, somewhat suddenly from five- to twenty-eight, but quarantin (fourteen days, inclusive of time at sea) was at once imposed in Egyptian ports, and tin quarantine was not taken off at Suez until the 27th June, five days after the commence ment of the outbreak at Damietta, though the weekly number of deaths in Bombay froi cholera had by the sth June once more receded to four. E Since July 6, 1882, I have had the honour to hold the position of British Delegate the Sanitary Council, whose responsible duty it is to protect Egypt from the imporon of disease. Before I became a member cf this body, general and specific Eules action had been framed by a Committee of its members. These Rules were duly pted by the Board in the autumn of 1882, and have since that time formed the basis My voting power on the Board is very small, as I have only one voice among its twenty-two other members ; but, acting in accordance, as I believe, with the spirit and letter of the instructions conveyed to me from Her Majesty's Government, I have uniformly endeavoured to secure that the Board should not capriciously set aside its own Eules, or, by imposing absurd or vexatious quarantines, go beyond them. Her Majesty's Government, while approving my course of action, have, it is true sent me from time to time fresh instructions in this same sense, but I have neve received instructions to interfere with, or in any way to endeavour to over-ride, th Quarantine Regulations framed by the Board itself for the preservation of Egypt, no have such Regulations in any single instance been relaxed in consequence of represents tions, direct or indirect, from England. True, I have fought many a battle with my colleagues in the interests of British ship-owners and of the vast British commerce with the East, but I emphatically assert (and I might appeal to the official records to substantiate my assertion) that I have never for a moment allowed the interests of commerce to in any way take the first place to the danger of the public health. I have doubtless protested strongly and repeatedly 14 Knst sudden and arbitrary changes in the Regulations, but I have always held the ervation of Egypt to be my first duty, and have only, as a secondary though veiy >rtant consideration, striven to secure that, in affording Egypt protection, undue and vexatious restraints should not be placed on trade and navigation. If I have travelled somewhat beyond the immediate question at issue, I have done so in order to show that no relaxation of precautions has at any time taken place in consequence of British interference. (Signed) WALTER F. MIEVILLE. Alexandria, July 4, 1883. No. S. Sir E. Malet to Earl Granville. — (Received July IG.) (Telegraphic.) Cairo, July 16, 1883, B'4o A.M. THE following seven European doctors have been sent by the Board of Health to the infected places: — Drs. Winkler, Ingigliardi, Dutrieux, Romano, Ferrari, Flood, Hasper ; also six Egyptian doctors possessing European diplomas. No. 9. Sir E. Malet to Earl Granville. — (Received July 17, 1 1*5 a.m.) (Telegraphic.) Cairo, July 17, 1883, 11 A.M. THE sanitary cordons, which produce great hardship on the population, and can only be justified so long as they keep the cholera from spreading, are about to be removed on account of the disease having appeared in so many places that they are considered needless. It is intended that a discussion shall take place and a decision be come to to-day as to isolating Alexandria and Ismailia. No. 10. Sir E. Malet to Earl Granville. — (Received by telegraph, July 18.) My Lord, Cairo, July 18, 1883. I HAVE the honour to inform your Lordship that, seeing the spread of the cholera in many parts of the country, the Government of His Highness the Khedive would be obliged if Her Majesty's Government would send out as soon as possible twelve doctors; and they at the same time beg that, pending their arrival, the military doctors may be authorized to lend their assistance. I have, &c. (Signed) EDWARD B. MALET. No. 11. Consul Cookson to Earl Granville. — (Received July 19.) My Lord, Alexandria, July 10, 1883. I HAVE the honour to forward to your Lordship herewith a despatch addressed to me by Mr. Mieville respecting the progress of the cholera outbreak at Damietta, and the measures taken by the Egyptian Government. I have, &c. (Signed) CHAS. A. COOKSON. 15 t Inclosure 1 in No. 1 1 . Consul Mieville to Consul Cookson. Sir, Alexandria, July 10, 1883. I HAVE the honour to forward herewith copy of a letter, dated the 30th June, addressed to the President of the Quarantine and Maritime Sanitary Council by Dr. Ferrari, the quarantine officer at Damietta, respecting the measures which had up to that date been taken by the Government to grapple with and prevent the spread of the disease. Dr. Ferrari reports the arrival of three doctors, to each of whom a district was at once, allotted, and a chemist, who was immediately sent to the hospital where, it would seem that, prior to his arrival, much delay had been experienced before prescriptions were made up and dispensed. The letter goes on to say that with this help it was hoped that the mortality would decrease daily (which has happily actually been the case) and the disease be stamped out. Mention is then made of the number of carcases of animals that daily continued to drift down the Nile, many being stopped as heretofore by the rushes near the town itself. I should add, however, that the Egyptian Government have since taken active measures to have these carcases removed, and that by the 6th instant sixty had been buried. ¦The Report ends by detailing the outposts and line of the sanitary cordon. This, ver, has doubtless been now modified considerably, as, since the 30th June, the se has spread greatly. fl inclose official copy of the most complete Table as yet procurable of the total ortality at Damietta from the 20th to the 28th June. I further inclose a copy of the supplement of the official " Moniteur Elgyptien," etailing the measures taken by the Government up to yesterday. The statement in ;he fourth paragraph from the end, to the effect that the Commission sent to Damietta eclared the cholera to be " Asiatic," is not, I submit, borne out by the Report which ccompanied my despatch of the 29th June. I have, &c. (Signed) W. P. MI^VILLE, British Delegate. Inclosure 2 in No. 1 1 . Dr. Ferrari to Dr. Hassan. Damiette, le 30 Juin, 1883. E'AI tardejusqu'a present a vousexpedier cc Rapport, et e'est en attendant toujours cc dcs medecins pour pouvoir informer votre Excellence dcs mesures gui auraient ises. Aujourd'hui, a 3 heures de l'apres-midi, un train est arrive portant avec lvi trois medecins et un pharmacien. Les medecins ont et^ ordonne de se placer un a chaque quartier, comme je l'avais propose a son Excellence le Gouverneur, et tel quo je vous l'avais telegraphic. Le pharmacien a etc tout de suite envoye a Ph6pital pour servir sans perte de temps toute recette medicale gui lvi sera presentee, attendu que durant ces derniers jours pour se procurer un peu de medicaments on devait recourir aux "attarines" (droguistes Arabes) de la ville si on voulait etre servi illico ; autrement, si on devait se les procurer do l'hdpital on etait sur de pouvoir les obtenir une fois le malade expire, yu le grand temps qu'on etait oblige de perdre a remplir une multitude de formalites avant de les obtenir. hEn cc moment j'espere qu'en faisant chacun son devoir, comme je suis sur, on era a obtenir le nombre journalier dcs attaques, chose gui a eb& impossible jusqu'a nt, et par les soins gui peuvent etre prodigue's actuellement aux malades avec mveau personr?! on arrivera aussi, je l'espere, a eteindre le fldau. Je me permets aussi de faire observer a votre Excellence que le nombre dcs charrognes de boeufs et de buffles sans peaux ne cesse d'augmenter chaque jour passant le Nil au milieu de cette ville, le courant les portent sur les rives ou. elles stationnent entre les roseaux et repandent dcs exhalations gui, avec les chaleurs actuels, votre Excellence pourra bien juger de quel danger peuvent etre a la sante publique. ¦Ie cordon sanitaire est compose actuellement de 400 soldats, commandes par ol Agassi Mohamed Effendi Akif, et sous les ordres de M. l'lnspecteur Sanitaire, Romano, et se trouve place autour de la ville de la maniere suivante : — 16 (a.) Sur la route de la Province Dakahlieh, trois postes de garde com mo suit 1. El-Enanieh embouchure reliant le Nil avec le Lac Menzaleh. 2. Kantara El-Beda, pont etabli surle susdit Canal El-Enanieh. 3. Ezbet El- Said Nehman Bakri. (b.) Sur la route conduisant a Port-Said et Zagazig (bords dv Lac Menzaleh), six postes, comme suit : — 1 . Debarcadere Mehebbe. 2. „ Chat El-Sayaleh. 3. „ Chat Guet El-Massara. 4. „ Chek Chata. 5. „ Les Salines. 6. „ Fort a Test dv Bogar (embouchure sur la route de Port-Said, voie de terre). (c.) Sur la route conduisant a Tantaha l'ouest dv Nil, quatrc postes, comme suit : — 1. Fort contigu a l'Abadieh El-Manchidi, propriete de Hassan Bey El Markabi. 2. Point sur la ligne dv chemin de fer dominant la route dcs Salines de Cafr-el- Battih. 3. Fort flo. 3. 4. Chemin contigu a l'usine de l'Abadieh de M. Basile Fakre. Le caractere de l'e'pidemie est toujours le me'me en ville ; cependant, je suis heureux de vous fairc connaitre qua l'Ezbet il ny a eu jusqu'a present aucun cas. L'etat de'taille de la mortalite generale, je vous l'adresserai demain, m'ayant manque le temps necessaire pour le finir. Veuillez, &c. Le Directeur, (Sign 6) Dr. FERRARI. (Translation.) Damietta, June 30, 1883. I HAVE waited till now to send off this Report, so as to be able to inform your Excellency of the measures taken on the arrival of the doctors. To-day at 3 p.m. a train arrived bringing three doctors and a druggist. The doctors were ordered to place themselves one in each quarter of the town, as I had proposed to his Excellency the Governor, and as I had telegraphed to you. The druggist was at once sent to the hospital in order that he might be able to dispense without delay any prescription that might be handed to him, because lately, in order to get any medicines then and there, it had been necessary to go to the " attarincs " (Arab druggists), for if the medicines were sought at the hospital, the patient was sure to die before they could be obtained, owing to the numerous formalities which had to be gone through. I hope that now, if all do their duty, as I am sure they will, the daily number of cases will be obtained, which has not been possible hitherto, and I hope also that the care which the arrival of the doctors will render it possible to give to the sick will stamp out the disease. I would also point out to your Excellency that the number of skinned carcases of oxen and buffaloes continues to increase daily, as the current of the Nile as it passes through the town carries them to the banks, where they stop in the reeds and give out exhalations, of the danger of which to the public health in such heat your Excellency can well judge. The sanitary cordon, which is now composed of 400 soldiers commanded by the Sakol Agassi Mohamed Effendi Akif, is under the orders of the Sanitary Inspector, Dr. de Romano, and is placed round the town in the following manner : — (a.) On the road to the Dakahlieh Province three guards as follows : — 1. El-Enanieh, the junction of the Nile and Lake Menzaleh. 2. Kantara El-Beda, the bridge over the above-mentioned El-Enanieh Canal. 3. Ezbet El-Said Nehman Bakri. (b.) On the road to Port Said and Zagazig (banks of Lake Menzaleh), six guards, as follows : — 1. Landing stage at Mehebbe. 2 Chat El-Sayaleh. _j 3' 3. „ . Chat Guet El-Massara. 4. „ Chek Chata. 5. „ The Salt Works. 6. „ The fort to the east of the Bogar (the mouth on the Port c.) On the road leading to Tantah to the west of the Nile, four guards, as rs:— ¦.. Fort close to the Abadieh El-Manchidi, the property of Hassan Bey El- 2. Point on railway above the Salt Works of Cafr-el-Battih 3. Fort No. 3. 4. Road close to M. Basile Fakre's works at the Abadieh. r In the town the character of the epidemic remains the same; but I am happy to able to inform you that there has been as yet no case at Ezbet. LI will send you the detailed accounts of the general mortality to-morrow, as I not had time to finish them yet. I have, &c. (Signed) Dr. FERRARI, Director. Inclosure 3 in No. 1 1 . Tableau de la Mortalite a Damiette dv 20 au 28 Juin, 1883. Sexes, Date. Total. Observations. Hommes. Femmes. Garc.ons. Filles. ,', 22 *.. 2 8 4 5 14 „ 23 .. 4/12 2 5 23 „ 24 ..4 8 8 5 25 Dont 15 suspects. „25 .. ..12 13 6 11 42 „ 32 „ „26 .. 7 10 19 11 47 „ 37 „ „ 27 ... .. 31 30 38 30 129 „ 113 de cholera. ?28 .. .. 22 22 39 23 106 „ 101 „ Total .." .. 82 99 119 91 391 298 Inclosure 4 in No. 1 1 . Supplement to the " Moniteur Egyptien" of July 9, 1883. SON Excellence Salem Pacha, President dv Cons^ »"•* Santd et d'Hygie"ne Publique, a adresse* a Son Altesse le Khedive le Eapport suramt sur les mesures prises par le Conseil de Sante" et d'Hygiene Publique en vue d'empe'cher l'extension dv cholera et de l*e*touffer dans les foyers oil il a et^ imports. R, Dcs l'annonce de l'apparition dune maladie suspecte de cholera a Damiette, n, le President dv Conseil de Sante et d'Hygiene Publique y faisait envoyer les ins-en-chef dcs Provinces Garbieh et Dakahlieh pour s'assurer de la nature de la maladie et prendre les mesures opportunes ; il priait ensuite le Ministere de l'lnte'rieur, par de'peche, de faire suspendre les communications et organiser un cordon. 2. Le Miniature de l'lnterieur, de son c6te, envoyait dcs le 24 Juin une Commission, composee de MM. les Drs. Dacorogna Bey, Ahmet Bey Hamdi, Grant Bey, et Abdel Rahman Bey Herraoui, charge'e d'e'tudier la maladie. Cette Commission s'unit a Damiette a celle envoyee par le Conseil Sanitaire Maritime et Quarantenaire, ct redigea ensemble un Rapport. Mais avant de quitter Damiette, elle cut soin de prescrire dcs mesures d'isolement, de disinfection, &c, et d'adresser dcs recommandations dans I'inte're't publique. La Commission retourna au Caire, et le jour me'me de nouveaux ordres furent donnas pour l'interruption de communication avec Damiette et l'organisation dun cordon. Peu d'heures apr£s, le Medecin-en-chef de la Dakahlieh annoncait la constatation de deux cas de cholera i Mansourah, et dcs mesures d'urgence furent prises. La maladie a, depuis, pris de plus grandes proportions a Damiette et Mansourah, et s'est manifestee a Port-Said, Samanoud, et Cherbine ; un cas sporadique a e'te constate a Tantah et un autre a Alexandrie ; dans toutes ces derni^res localites les premieres personnes atteintes provenaient de Damiette. Le Conseil de Sant6 et d'Hygiene Publique, d'accord avec Son Excellence le Ministre de l'lnte'rieur, dont le concours constant et pre"cieux assurait l'exe'cution de ses decisions, forma autour de toutes les localites atteintes un cordon bien organise* de 17 18 lacs, sous le commandement d'officiers supdrieurs et la surveillance dcs Inspecteurs le Romano pour Damiette, Dr. Mahmoud Sidki pour Mansourah, et envoya dans une de ces locality un personnel medical et pharmaceutique nombreux et capable, ne'dicaments et disinfectants en grande quantity. BDes mesures d'hygiene et de salubrite out etc ordonne'es et executees non seuledans les villes atteintes mais dans toute l'figypte et principalement an Caire et a andrie. Ces mesures consistent : Dans la surveillance dcs inarches, abattoirs, ct lieux publics ; l'interdiction de la vente dv poisson appele " fissibs," la saisie dv poisson frais, dcs legumes, fruits, et de toutes les substances livrees a la consommation gui seraient trouvees gatees ou alterees. La defense de transporter le "fissih," les peaux fraiches ou non iannees, les os et chiffons gui devront etre enfermes dans dcs magasins speeiaux. .Surveiller les canaux, fleuve, empecher qu'on y jette dcs animaux morts, retirer et faire enfouir ceux gui s'y trouvent. Un service d'inspection sur le fleuve et les canaux a 6te organise et confix a Mr. Goodall. Desinfection dcs latrines dcs mosquees, casernes, prisons, ecoles et autres etablissements publics ; les conduits dcs mosquees devront etre desinf ectes et mures. Desinfecter les. maisons ou il y a eu dcs malades atteints de cholera, bruler les hardes et effets ayant appartenu aux morts. Organiser dcs services de desinfection pour la correspondance provenant de Damiette, Mansourah, Port-Said. Installer dcs hopitaux pour les choleriques a Damiette, Mansourah, et Port-Said, en pre'parer un au Caire pouvant contenir 200 malades pour toutes eventualites. Faire boucher les conduits dcs maisons et dcs egouts s£ jetant dans le Halig gui a etc desinfecte en y jetant la chaux vive sur tout son parcours et principalement dans les endroits ou il y a dcs eaux stagnantes. Pour Damiette, il a etc ordonrie de disperser la population dcs quartiers contaniines hors de la ville et dans l'enceinte dv cordon sanitaire efeabli. Dcs tentes, dcs gourbis en mattes, et dcs barraques en bois ont.ele dresses pour recevoir les habitants; leurs habitations seront scrupuleusement desinfecte'es, dcs masures demolies et detruites ; les hardes et vetements dcs choleriques morts seront brules. La Commission Sanitaire Permanente, a laquelle prennent part son Excellence le' Ministre de I'lnterieur, 1c Prefet de Police, le Commandant-en-chef de la Gendarmerie, et le Sous-Ministre dcs Travaux Publics ordonne et fait exe"cuter d'urgence toutes les mesures gui sont adoptees et propres a ameliorer ou assurer la salubrite publique. Toutes ces mesures ont arrete la marche de la maladie gui, dans I'epidemie de 1865, avait en' peu de jours envahi toute TEgypte, tandis que cette foisily a dejaquatorze jours qu'elle a fait son apparition et elle est restde circonscrite a quelques localites. Cette maladie est bien le cholera Asiatique, ainsi que la constate la Commission envoyee a Damiette, et le Eapport adress^ par le Medecin Sanitaire de Port-Said de"montre que les sympt6mes sont bien caracteristiques et bien ceux dv cholera Asiatique. Or, la Conference Internationale de Constantinople a conside"r6 comme d6montre que le cholera Asiatique envahissant ne s'est jamais de'veloppe' spontan^ment et na jamais 6t6 observe a l'etat endemique eh Europe et en Egypte et qu'il est toujours venu dv dehors, merae au Hedjaz, ou le cholera se de'veloppe souvent. La Conference retient qu'il ne parait pas y avoir un foyer originel mais qu'il semble y avoir et6 jusque la toujours importe dv dehors. Ces conclusions viennent confirmer l'opinion dv Conseil de Sante que le cholera a dv, etre importe dv dehors, et dcs recherches sont faites pour arriver a decouvrir son origine a Damiette, et il espere qu'elles aboutiront a un bon r^sultat. (Translation.) HIS Excellency Salem Pasha, President of the Public Health and Sanitary Board, has sent to His Highness the Khedive the following Report on the measures aken by the Public Health and Sanitary Board with the view of preventing the extension of the cholera and of stamping it out at the centres of infection to which i has been brought. 1. As soon as the President of the Public Health and Sanitary Board was informed that an iUness, suspected to be cholera, had appeared at Damietta on the 23rd June, he sent thither the chief medical men of the Provinces of Garbieh and 19 ¦hlieh to ascertain the nature of the malady, and to take such measures as might ecessary. He then begged the Minister of the Interior by telegram to stop mnications and to establish a cordon. 2. On the 24th June the Minister of the Interior sent a Committee, consisting of Drs. Dacorogna Bey, Ahmet Bey Hamdi, Grant Bey, and Abdel Rahman Bey Herraoui, with instructions to investigate the disease. At Damietta this Committee joined that which had been sent by the Maritime Sanitary and Quarantine Board, and the two together drew up a Report. But before leaving Damietta the Committee ordered steps to be taken for isolation, disinfection, &c, and for issuing instructions and advice to the public. The Committee returned to Cairo, and the same day fresh orders were given to interrupt communications with Damietta and to organize a cordon. A few hours afterwards the chief doctor of Dakahlieh announced the existence of two cases of cholera at Mansourah, and urgent measures were taken. Since then the disease has assumed larger proportions at Damietta and Mansourah, and cases have occurred at Port Said, Samanoud, and Sherbin ; a sporadic case occurred at Tantah, and another at Alexandria. In all these latter places the persons first attacked had come from Damietta. The Public Health and Sanitary Board, with the concurrence of his Excellency the Minister of the Interior, whose constant and valuable assistance insure the execution of its decisions, formed round the infected spots well-organized cordons of troops under the command of superior officers, and under the supervision of the Inspectors Dr. de Romano for Damietta, and Dr. Mahmoud Sidki for Mansourah, and sent to each of those places a large number of efficient medical men and druggists, and a large quantity of medicines and disinfectants. Hygienic and sanitary measures have been ordered and executed, not only in the towns which have been attacked, but throughout Egypt, particularly at Cairo and Alexandria. These measures arc as follows :—: — The supervision of markets, slaughter-houses, and public places ; the prohibition of the sale of the fish called "fissihs," the seizure of fresh fish, vegetables, fruit, or of any food offered for sale and found to be spoilt or tainted. The prohibition of the transport of " fissihs," of fresh or untanned hides, of bones and of rags, which must be placed in special warehouses. The superintendence of the river and canals so as to prevent dead animals being thrown into them, and to have those which are in them taken out and buried. A service of inspection of the river and canals has been organized and intrusted to Mr. Goodall. The disinfection of the latrines of the mosques, barracks, prisons, schools, and other public establishments ; the drains of the mosques will be disinfected and walled To disinfect the houses where there have been patients attacked by cholera, and to burn the rags and clothes of those who have died. BTo organize a service for the disinfection of correspondence from Damietta, sourah, and Port Said. E'o start hospitals for the cholera patients at Damietta, Mansourah, and Port and to establish one at Cairo to contain 200 patients, in case it should be i. To close up the house and street drains emptying themselves into the Halig, which has been disinfected by throwing quicklime into it throughout its course, and more particularly at the stagnant places. yrders have been given to remove the population of the infected quarters of tta to places outside the town, but inside the sanitary cordon which has been E'ents, "gourbis," and wooden huts have been put up to receive the inhabitants ; dwellings will be carefully disinfected, the hovels will be demolished and yed, and the rags and clothes of deceased cholera patients will be burnt. The Permanent Sanitary Committee, of which his Excellency the Minister of the Interior, the Prefect of Police, the Commander-in-chief of the Constabulary, and the Under-Minister of Public Works are members, orders all the measures Avhich are adopted, and are calculated to insure the protection of public health, and has them executed at once. These measures have arrested the progress of the disease, which, in the epidemic of 1865, had in a few days spread over the whole of Egypt ; whilst, in this instance, [1523] D 2 20 fourteen days have elapsed since its appearance, and it has remained localized in a lew lAs the Committee sent to Damietta has ascertained, the disease is Asiatic jra ; and the Report sent in by the Sanitary Doctor of Port Said shows that the )toms are very marked, and are undoubtedly those of Asiatic cholera. I The International Conference at Constantinople considered it proved that jmic Asiatic cholera has never developed itself spontaneously, and that it has r been observed in the endemic state in Europe or in Egypt, and that it has ys come from without, even at Hedjaz, where outbreaks are frequent. The Conference abides by the opinion that there never seems to have been an original focus, but that the cholera always seems heretofore to have been imported from without. These conclusions confirm the Board of Health in its opinion that the cholera must have been imported, and investigations are being made to discover its origin at Damietta, and it is hoped that they will be successful. Ko. 12. Consul Cookson to Earl Granville. — (Received July 19.) My Lord, Alexandria, July 10, 1883. I HAVE the honour to transmit herewith, under flying seal, two despatches, dated respectively the 7th and 9th instant, addressed to your Lordship by Dr. Mackie, Consular Surgeon at Alexandria, respecting the recent outbreak of cholera at Damietta. I have, &c. (Signed) CHAS. A. COOKSON. Inclosure 1 in Ko. 12. Dr. Mackie to Earl Granville. (Extract.) Alexandria, July 7, 1883. I REGRET that up to the present I have been unable to obtain precise information with regard to the outbreak of cholera at Damietta, as no attempt at inquiry has yet been made to endeavour to arrive at a knowledge of its origin or cause. The existence of V suspected cholera " at Damietta was first made known in Alexandria on Saturday, the 23rd June, with eleven cases for that day, and I believe the first intelligence was conveyed by telegram from private individuals at Damietta. At 10 a.m. on Sunday, the 24th, I called on Dr. Salem Pasha, chief of the Egyptian Sanitary Administration, and found that he had only then heard of it officially, and that it was decided to send a Medical Commission next morning to Damietta to inquire into the truth of the reports and the nature of the malady which had appeared at Damietta. During the day of Sunday I learned by private telegram from Cairo that a Medical Commission was to leave Cairo at 1 p.m. by special train for Damietta. lat once communicated this information to Dr. Hassan Pasha Mahmoud, President of the Maritime and Quarantine Sanitary Board, and it was at once decided to send a Commission from that Board to join the Cairo Commission at Damietta. Dr. Chaffey Bey (Egyptian), who has had great experience of cholera at Jeddah and Mecca ; and Dr. Ardouin Bey, Sanitary Inspector of the Quarantine Sanitary Board, left Alexandria at 6 p.m., and next day (Monday) met in consultation their confreres of the Cairo Commission. After visiting several cases, the Commission pronounced the disease undoubted epidemic cholera ; but the inquiry did not go beyond this. The members left Damietta on Monday forenoon, and proceeded to Cairo to draw up their Report, but, unfortunately, without obtaining a clue to the origin of the outbreak. As soon as the members of the Commission left, a cordon sanitaire was established, and railway communication interrupted at Ras-el-Khalig, about 13 miles from Damietta. In the proccs-verbal drawn up by the members of the Commission they state that "it was found impossible, notwithstanding their inquiries, to determine the origin of the outbreak or specify whether it was of local origin or had been imported." The Italian Delegate to the Quarantine Board and I proposed, therefore, that another Commission should be dispatched at once, to study the disease, to try to find out its history, and trace its origin. This met with great opposition, and had to be 21 abandoned, chiefly from the impossibility of finding medical men (whose opinion was ot value) to undertake the mission, on account of the long quarantine to be undergone on returning from Damietta ; those engaged in active work here not being able to afford It was decided, after a few days, that Dr. Chaffey Bey, who has no active employment to necessitate his return here at present, should proceed to Damietta and remain there, to assist with his counsel and experience the Executive authorities, and endeavour to obtain information of the origin of the outbreak. I hope that interesting and useful information will be collected by this willing, intelligent, and energetic employe" of the Maritime and Quarantine Board. The suddenness of the outbreak seems to have paralyzed the intelligence of the Egyptian authorities. Their first act was to establish a cordon sanitaire, thus preventing all egress, and leaving the unfortunate inhabitants of Damietta to die without help or succour, or chance of escape. For days after the disease broke out telegrams were received daily, complaining of the total want of doctors, medicines, disinfectants, &c. In a town of which the population is stated at 35,000 there seems to have been no organized medical nor hospital service, no help of any sort for rich or poor. They were shut in by a cordon, and left at the mercy of the disease to die in numbers and propagate cholera. No endeavour was made to save the people and stamp out the disease, by driving the inhabitants from the infected part of the town, and camping them out in some healthy place, supplied with good food and water. This they are now doing to some extent. On the 30th June, Dr. Chaffey Bey writes: "Aujourd'hui, a 3 heures de l'apre's-midi, un train est arrive portant avec lvi trois medecins et un pharmacien," &c. This is the first information we have of help being sent — a week after the outbreak of the disease, when the mortality had reached upwards of a hundred daily. Until a proper inquiry is made into the origin of the outbreak, whether local or imported, any opinion on the point at present must be more or less speculative. It is matter of experience that outbreaks of zymotic diseases generally are favoured by conditions which certainly have existed in Egypt for some time; whether these conditious or causes contained the necessary germ or material for the production of cholera research may or may not with certainty establish. For some time past cattle disease (bovine typhus) has been raging epidemically in the delta of the Nile. It has been matter of current report, and, I may say, of general belief, for some time, that many diseased cattle were slaughtered by the fellaheen and sold in the bazaars of the villages for food. To save the expense and trouble of burying those that died, it was and is a common practice to remove the skins and pitch the carcasses into the Nile or nearest canal. The Damietta branch of the Nile, especially in its lower part, from Samanoud and Mansourah, seems to have been particularly favoured in this respect, for the local European press had been for some time receiving information from correspondents at those places that carcasses of animals were constantly floating down the Nile, exhaling a most offensive odour. Dr. Chaffey Bey, in his letter of the 30th June, to which I have referred, says: "Je me peimets aussi de faire observer que le nombre dcs charrognes de bceufs et de buffles sans peaux ne cessent d'augmenter chaqne jour passant le Nil au milieu de cette ville, le courant les portent sur les rives ou elles stationncnt entre les roseaux et repandent dcs exhalations gui avec les chalcurs actuels on pourra bien juger de quel danger peuvent etre a la sante* publique;" The inhabitants, in addition to breathing this poisoned atmosphere, take their water supply directly from the Nile, which, in addition, is about its lowest at this season. It is also subject of report and belief here that natives have been known to drag the carcasses from the river and use them as food. I make this statement with reserve, for although I haye heard it repeatedly stated, lam loath to believe it. The heat at the outbreak of the disease, and for some time previously, had been excessive and oppressive, with damp atmosphere. The uncleanliness of the town of Damietta, like every Egyptian town, is reported to be abominable, and the inhabitants particularly uncleanly in their persons, their food, and their habits. At the time of the outbreak of the disease a large fair, at which it is estimated that 10,000 people were collected, was being held at Damietta. The Medical Commission, before establishing the cordon sanitaire, ordered the people collected at the fair to be dispersed. Such are some of the local causes which would be supposed to favoui the development of zymotic disease. Those who hold that the disease can have originated only by importation pretend that it has been imported from Bombay, and a report has gained a little credence that two Bombay merchants, just arrived in Egypt, were at Damietta fair, and that they brought the germs of the disease either by their persons or their merchandize. I have not been able to trace those two Bombay merchants, nor find out if they showed any 22 Bfcoms of cholera. Those who hold that the disease has been imported urge, as ft ? reason for this opinion, that cholera has never originated spontaneously in Egypt, hat a short time before the outbreak in Egypt, cholera had assumed a more severe form in Bombay. The precise manner or means by which it has been imported has no been stated, except the report, believed in by some, of the two Bombay merchants, ant others of a similar character, such as, for instance, that a fireman ran away from an India steamer at Port Said, and made straight for Damietta. Those who believe in importatio Jby those means forget, or are ignorant of the fact, that at the time that the two merchan of Bombay must have arrived in Egypt there was a long quarantine at Egyptian port in the Eed Sea against India, which those gentlemen must have undergone before settin foot in Egypt. There remains for them their other argument, that cholera germs ma have been conveyed by their merchandize, that they may have been lying dormant in th merchandize for an indefinite period, and escaped destruction by the quarantine disin fection. This, were it likely to be possible, would prove more than anything else th uselessness of quarantine. They forget also, or do not mention, that when our India contingent arrived in Egypt last summer cholera was prevailing in Bombay, and no cas happened among the troops or camp followers, nor was imported by the mass of clothes merchandize, material of all sorts which such an equipment must have brought with i It is still further brought forward as argument, that as the precise nature of cholera gem or infection is not known some peculiar condition may be necessary for its development and that this year, though not last, the necessary conditions existed and the importec germ gave rise to cholera. Here we come to a combination of an imported and loca origin; but without proofs, which we at present do not possess, I cannot believe that with a rigorous quarantine (even if a quarantine was necessary) against India, it can have been imported to Damietta. The reasons seem very strong in favour of a local origin. When I compare wlmt information we have of this outbreak with my recollections of the severe epidemic of Asiatic cholera which visited Egypt in 1865, I am inclined to believe that it has had its origin in local causes, and will not spread to any alarming extent. The 10,000 people that were dispersed from Damietta fair do not seem to have had cholera amongst them or to have carried cholera with them throughout the length and breadth of Egypt, as they certainly would have done in 1865. At the time of their dispersion the deaths from cholera were already about forty daily, and the type of the disease virulent, — recoveries rare, and death occurring in very many cases after from four to ten hours' illness. The disease has now been prevailing for sixteen days according to our information, and, with the exception of a few cases in Port Said and Tantah, and two of suspected cholera in Alexandria, has been limited to the small district from Damietta to Samanoud. In the epidemic of 1865 the whole country was invaded in less time, and the mortality excessive. The towns of Damietta, Cherbin, Menzaleh, Mansourah, *and Samanoud are within short distances of each other, and are all exposed to similar local influences. Some at least, if not all, of the cases at Port Said and Tantah are reported to have been refugees from Damietta, but exact information is yet wanting, and cannot be got from the sanitary authorities to whom I have officially applied. Two separate small outbreaks have taken place at Port Said, counting a few victims each, and each time have disappeared. This is hardly the usual course of severe Asiatic cholera. Another reason for believing that some local cause was at work is, that at the outbreak of the, disease the daily mortality from general diseases also increased very much. The ordinary mortality of Damietta from general diseases, which is four daily, according to sanitary returns, mounted up to fourteen and fifteen daily, as the deaths from cholera reached their daily maximum, and was increasing rapidly for days before cholera was announced ; and now the daily mortality from cholera and general diseases have both considerably diminished, the latter being reduced to about ordinary rate. What the general diseases were which increased the death rate I have been unable to find out, the Central Sanitary Board having no information, and the cordon sanitaire and quarantine prevent one from going to the spot to learn for ones-self. My recollection of the epidemic of Asiatic cholera of 1865 is, that there was a diminution in death returns from general diseases, and that there were few deaths from any disease but cholera. This, however, admits of explanation, and may be taken for what it is worth. The sanitary arrangements of the country are as bad as they were in 1865 — it is but little changed in that respect. In some of the larger towns, Alexandria, Cairo, &c, magnificent blocks of buildings have been erected, streets paved, &c, but unfortunately all has been done with the most perfect disregard of the first principles of sanitary science, and Alexandria at present, with its vile system of sewers, house drains, and 23 zymotic diseases. Many of the sewers have not been cleaned since they were constructed, and they are so constructed that it is next to impossible to clean them. None .-of -the. closets, drains, nor sewers are either trapped or ventilated, and the town is full of stinking cesspools. The Europeans and Levantines, especially Syrian house proprietors, surpass the natives even in the construction of unhealthy houses. An energetic effort to, cleanse the town is being made by a combined Consular, Medical, and Mercantile Extraordinary Sanitary Commission, composed of forty-four members (Europeans and natives), under the presidency of the Governor of Alexandria, the originating of which is chiefly due to representations made to his Excellency Cherif Pasha by Mr. Anslyn, Consul-General for the Netherlands, and by Mr. Consul Cookson. This will do some good work in cleansing bazaars, public places, and the exterior of the town ; but the house closets untrapped, communicating with filthy drains, and cesspools, and sewers unventilated, leaking soil pipes, or rather holes down the centre of walls serving for soil pipes, and allowing extensive leakage, open latrines for servants ie the very centre of the kitchens, will still remain to convey infection from family to family, from house to house ; ami if cholera visits us it is bound to spread, in spite of all that the Extraordinary Sanitary Commission can do. Such is a fair description of the houses of which rich Egyptians and Levantines are proprietors, and for half a floor of which we are obliged to pay a yearly rent of from 150/. to 200/. Many of the diseases and illnesses contracted in Egypt, and attributed to climate, are solely attributable to bad house drainage. The Egyptian Government is, as usual, receiving its share of praise and blame for measures taken or neglected to stop this epidemic. Many Europeans, medical men and others, who blame them for not stopping the epidemic, praise loudly the institution of the cordon sanitaire : give them a cordon sanitaire or quarantine, and they are given a feeling of safety. I believe that the cordon sanitaire was the worst means that could have been adopted — I mean as they imposed it. The cordon gave a feeling of. safety to , outsiders, while the inhabitants were left to die within it neglected, to propagate cholera ; and the authorities had a day or two to reflect, and make their preparations for the next step. Had they evacuated at once the infected part of the town, and placed a cordon to prevent the return of the inhabitants to it, as well as their communication with other villages, I think the disease might have been stamped out. But the Egyptian has no appreciation nor experience of good sanitary arrangements, which he has never seen and never learnt. The sympathy of class for class is too little developed, if it exists at all ; their value of life is too low to stimulate them to energetic action. Fatalism also has its effect. The Egyptian in this respect is the Egyptian of a hundred years ago, and deserves help more than blame ; but it must be help with authority. Inclosure 2 in No. 12. Dr. Mackie to Earl Granville. My Lord, Alexandria, July 9, 1883. SINCE writing my Report of the 7th instant another fatal case of cholera has occurred in this town : the victim was a strong bodied adult male of Austrian nationality. As soon as I heard of the case I went to satisfy myself personally, and found it ail undoubted case of cholera, though not of the severest type. Reaction never took place, the algid stage continuing till he died nineteen hours after he was taken ill. I put some questions to him, but he answered with difficulty ; he stated, however, that he had not been in the infected districts, nor as far as he was aware had he been in contact with any one who had been there. The attempt to attribute this outbreak of cholera to importation from Bombay has now assumed here a more formal shape than current reports. The Egyptian Government sanitary doctor at Port Said, Dr. Flood (a Norwegian), has published in the " Moniteur Elgyptien " an official letter written by him to the Board of Health, stating that on the 18th June a native of Upper Egypt named Mohamed Halifa, employed a,s fireman on board the British steamer " Timor," bound from Bombay to Naples, Scc.y was landed at Port Said, and at once proceeded to Damietta. He does not state noi pretend to know whether this man then or afterwards presented symptoms of cholera, nor whether he ever arrived at Damietta or was proved to be there, nor does he state any good reason why he did not infect the inhabitants of Port Said except perhaps that he left " immediately " without stating the time. He goes on to start a hypothesis, that 24 perhaps cholera had declared itself on board the " Timor " after leaving Bombay ; that it was in the period of incubation in this man at Port Said and declared itself at Damietta, but without being able to adduce any proof in support of this. As this letter is published in an official organ the theory is accepted by many here, and I think it would be useful to find out from the log-book of the vessel (1) whether the man was landed and if in good health ; (2) date of leaving Bombay, and state of health of crew on passage as far as Port Said and after. EThe sanitary doctor (a native) at Damietta has also reported in the same official in, that there were four Bombay merchants at Damietta fair, and he in his turn ts to them as the carriers of the infection. I am not aware that any mpt has been made by the sanitary administration or other to trace those men, :h ought not to be difficult. This is much to be regretted, as these reports have r advocates here and in Europe, and it would be in the interests of all that the origin he outbreak should be traced, if it can be traced, to its local or imported origin. Flood, sanitary physician at Port Said, mentions in a letter published to-day in the tare d' Alexandrie," that it is his belief that all the cases of cholera at Port Said up to 30th June (eight in number) were in people who had been at Damietta fair. Since 30th June only three more cases have been reported from Port Said (viz., on the July), and no attacks since then. I have, &c. (Signed) J. MACKCE. No. 13. Earl Granville to Sir E. Malet. (Telegraphic.) Foreign Office, July 19, 1883, 6*15 p.m. INFORM Egyptian Government that their request for doctors will be complied with.* No. 14. Earl Granville to Sir E. Malet. (Telegraphic.) Foreign Office, July 21, 1883, I*so P.M. EWAR OFFICE have authorized British medical officers to help the Egyptian ff, whenever they can do so without interfering with their military duties, until the glish doctors arrive.* No. 15. Earl Granville to Sir E. Malet. (Telegraphic.) Foreign Office, July 2l, 1883, 430 p.m. « THE Government of India have been requested to be in readiness to send Mahommedan doctors to Egypt should Egyptian Government want them. Telegraph direct to India. No. 16. Sir E. Malet to Earl Granville. — (Received July 21.) (Telegraphic.) Cairo, July 21, 1883, 9*30 a.m. I CALLED the attention of the Government to the question of the burials of the dead on the 17th instant, and received answer from the Minister cf the Interior that means were deficient, but that the matter already occupied the attention of the Government, and that he promised to do his best to remedy the evil. • No. 10. 25 No. 17. Sir E. Malet to Earl Granville. — (Received by telegraph, July 22.) My Lord, * Cairo, July 22, 188*. I[ HAVE the honour to report that, unmistakable signs having shown themselves le want of authority and of intelligent execution of orders in dealing with the ra here, I have asked Khairj" Pasha, the Minister of the Interior, to form a Comon with full powers both to give orders and to execute them. KFliis Commission is to consist of the members of the Ministry now in Cairo, with ddition of General Stephenson, Sir Evelyn Wood, and General Baker, which was with the concurrence of General Stephenson. His Excellency having confuted j proposal, they will meet to-day at 4 o'clock. I have, &c. (Signed) EDWARD B. MALET. No. 18. Earl Granville to Sir E. Malet. (Telegraphic.) Foreign Office, July 24, 1883, 4-10 p.m. B)RS. ACLAND and Gulliver leave for Alexandria this evening. Most, if not all, of hers will leave on Thursday. No. 19. Consul Cookson to Earl Granville'. — (Received August 2.) My Lord, Alexandria, July 22, 1 883. II HAVE the honour to report that, in consequence of the appearance of the ra at Damietta, the Consular Body of Alexandria met on the 26th June and ?d a Consular Committee to represent them, with the object of requesting the itian Government to appoint an Extraordinary Commission to take the sanitary ures necessary under present circumstances. The Consular Committee was constituted as follows : — M. Anslyn, Agent and Consul-General of the Netherlands. M. Dumreicher, Consul-General of Denmark. M. Byzantios, Agent and Consul-General of Greece. M. Heidenstam, Consul-General of Sweden. M. Machiavelli, Consul of Italy. M. Monge, Consul of France : and myself, as Consul of Great Britain. RChe same afternoon the Consular Commission had an interview with the Khedive c subject. His Highness received us with the greatest kindness, and assured us support and co-operation, and said that he would reply through the President of ouncil of Ministry. The next day, the 27th June, the Governor of Alexandria summoned the Consula Delegation, together with the doctors of the Quarantine Board of Alexandria, am read a letter from Cherif Pasha stating the proposed composition of the Commission But as we found the letter silent as to the powers of the Commission and the means t be given for carrying out its decisions, the Consular Delegation thought better to trea this letter as only an announcement of the intentions of the Government. W accordingly merely thanked the Government for the communication, and withdrew. M. Anslyn and I were therefore charged to see Cherif Pasha, which we die immediately, and represented to his Excellency the wishes of our colleagues. W asked that the Commission should be allowed the funds and police force necessary t carry out its decisions. His Excellency accepted willingly the co-operation which w offered him, but told us that the Government could only furnish the Commission wit funds through the Governor of Alexandria, who would also be ordered to provide th requisite police force, and he promised that an official letter in this sense shoulc be prepared. On the 28th June M. Anslyn and I had an interview with Tigrane Pasha, Sub- Minister of Foreign Affairs, at which we agreed to the terms of the letter to be f 15231 E 26 written to M. Anslyn, and on the 29th the Governor of Alexandria,. summoned the Consular Delegates, and read the despatch from Che'rif Pasha which had Been agreed upon by us. M. Anslyn received also the same day a letter in tlje same sense. At the meeting of the 29th it was agreed that the Governor, in his capacity of President, should summon the full Commission as soon as possible. Accordingly, yesterday, the Ist July, the Commission met, and the Governor read the letters from Cherif Pasha to himself and M. Anslyn. The Commission then proceeded to organize itself into an Executive Committee, three special Sub-Committees charged respectively with looking after the food and drink, the cleansing and the disinfection of the "town, and five local Sub-Committees, one for each of the four quarters of Alexandria and one for Ramleh. This morning the first meeting of the Executive Committee was held, when arrangements were made for the mode of meeting the expenses of the Commission, and the seven medical men in the Executive Committee undertook to draw up general instructions to the public on the precautions to be taken by every one during the continuance of the present disease. It may be hoped that the efforts thus being made will do much to improve tho sanitary condition of Alexandria, and to prepare it for an outbreak of cholera if one should unhappily take place. I have, &c. (Signed) CHAS. A. COOKSON. No. 20. Sir E. Malet to Earl Granville. — {Received July 25.) My Lord, Cairo, July 16, 1883. I HAVE the honour to inclose herewith copies of Reports from Mr. Murdoch British Consular Agent at Mansourah, respecting the cholera there. I have commun cated the contents of these Reports to the Minister of the Interior, and I believe tha they have been of great service in conveying the most accurate information which ha been sent from Mansourah as to what is passing. I gather from Mr. Murdoch accounts that, although there has been great anxiety lest provisions should _ fail, n such misfortune has actually taken place, and that provisions have mostly maintainec their normal prices ; but that a large number of refugees in a destitute state hay entered Mansourah, and that these have been exposed to much hardship, not from lac of provisions, but from lack of means to purchase them. I have not ceased my repre sentations to the Minister of the Interior on this point, and the complaint that ther were not enough doctors. I have the honour to inclose a copy of a letter, and ihclosure from his Excellency on the subject. I have, &c. (Signed) EDWARD B. MALET. Inclosure 1 in No. 20. Mr, Murdoch to Vice- Consul Borg. (Extract.) Mansourah, July 4, 1883. I AM sorry for the delay that has occurred in sending you the list of cholera cases here, but, on account of the great amount of extra work entailed on the authorities by this epidemic, I have had difficulty in obtaining correct lists of cases. I now beg to inclose list of cases to date, from which you will observe that the cholera has not made very much progress here as yet, although yesterday is the heaviest list of all, and I learn that fifteen deaths have been recorded to-day. The thermometric observations are taken from a Fahrenheit thermometer, and may be depended upon as being correct ; it is placed in the sitting-room of my house. The direction of the wind has been almost continuously north-west, and the slight change to west yesterday was accompanied by a little stronger breeze than usual. I have been unable to reckon tho time from midnight to midnight as you suggest, as the Sanitary authorities reckon, from sunset to sunset, and, although L instituted inquiries with a view id arranging my list as you desire, I found it impossible to ascertain exactly tjie hopr of each case of 4eath, and I have therefore takeii the list a,s 27 ask Dr. Sidky Bey to do so. IVo of the stagnant pools about the town have been filled up, but there are a good more that are not yet commenced, and I have impressed upon his Excellency qudir the importance of having these others done at once, and he has sent circulars proprietors of the land on which these pools are to have them filled up immev, and I understand the work is being proceeded with. Dead Carcases. — A number of men and a boat have been placed a considerable distance above the town, and any carcases that may come floating down are imniemediatcly taken out of the river and buried with quicklime, so that nuisance is abated. The cleaning and watering of the streets is being well looked after, and a number of persons have been sent to the houses of the poorer classes with chloride of lime, &c, and nearly all these houses that were in a dirty state have been well disinfected and cleansed. The disease has been for the most part confined to the quarter of Mit-Hadr, the most north-eastern, pr lower, part of the town, and it now appears to be gradually travelling southward, during these last two days the middle and most populous part of the town being most affected. Fruit and Vegetables have been entirely prohibited, and only such butcher-meat, as mutton, that has been passed by the sanitary authorities, allowed to enter the town. There is, however, a danger of running short of provisions caused by the refusal of the railway authorities to receive goods at Alexandria for Mansourah, and as this seems an absurd and unnecessary order, I hope the matter will be represented to the Railway Administration, and they will issue the order allowing the goods to be forwarded before the stock at present here reaches famine prices. Regarding the medicine at present employed in cholera cases here, I have questioned the doctors about it, but they show a reluctance to tell what medicine is most effective, and, as I have not pressed the matter, I do not know w r hat is used, but should you consider that the knowledge is necessary, I will do my best to obtain the information. A great deal of fear or dread exists among the Europeans, and I understand some of them have telegraphed to their Consuls- General to have a special train sent, as they are most anxious to get away, but I presume it is not possible till the quarantine is at an end. A good deai of the panic is due, no doubt, to the fact that there are so few doctors here (except those in' the employ of the Government) to attend to private patients. A statement appeared in the " Egyptian Gazette " to the effect that the doctors do not attend to their patients, and that there were no medicines, and not even bottles, in the hospital. From inquiries that I have made I do not think the first accusation is true, but the statement that there were no medicines is quite correct for the first two days of the epidemic, but Dr. Sidky brought a supply of medicines from Cairo, and I believe a good stock is at present here. The Moudir received a telegram yesterday requesting him to have fires in the streets all through the town, and I observe that the order has been carried out, and bonfires are general in the streets to-day. 28 Inclosure 2 in No. 20. List of Deaths from Cholera from June 25 to July 3, 1883, at Mansourah- Nationnlity. Age. Male. Female. Male. Female. Total. June 25, 1883 June 26 — Khalleel Burullusy . . . . . . Arab . . 2 > Said Solinvm . . . . » . . 25 1 Ibrnheen Elsahy .. .. •• »> ..38 1 .. Abdel Hameed-el-Soodany . . . . „ . . 25 1 Nabyieh Gabrial . . . . . . Pojit 15 1 . ____— 4 1 " Labeebeh, wife of C. Samne .. .. 1-evantine . . 35 1 Lateefeh Eldeebeh .. .. .. Arab ..25 .. 1 Ahmed Ibrnheem Aroes .. . . »» ..28 1 Wardeh Abdel Meseeh Uissk . . . . Copt . . 25 . . 1 DatnElyzz .. .. •• Arab .. 25 Snyedeh Negro . . . . . . »» . . 20 . . j Zuhrah Guneim .. .. . . „ .. 40 .. 1 Ahmed-el-Barbury .. .. .. Arab ..25 1 Fareeda Malaga . . . . »» . . 1 • • * All mod WagWftg .. .. •• m . . ¦40 Aly Ibrnheem . . . . • • » . . 25 1 HnmJch Oitnnn .. .. 20 Sabha, daughter of Mitwalli Noor . ? ..18 .. 1 Unmet Mohamed . . • . . . »i . . 8 1 . . Dusuky Abdel Wahab .. . . ..12 Abdel Aziz Elwasify . . >> 8 I . ' ¦ Co 9 Moh. Knmadun . . . . . . Arab . . 14 . . Ilmansy Ismael .. .. . . ? ..4 .. Aoheerez Matreesy . . . . . . Greek 20 1 Shubbayeb Elgnlonady . . . . Arab . . 60 . . 1 Moh. Abdel Galeel . . . . . . „ . . 40 Mansoor Moh. Elkharasawy . . . . „ 20 . . Ahmed Abul Wafa . . . . . . „ . . 85 1 __^__ July 1— Ismael Salim .. .. .. Arab ..12 1 Nafeesa Elshawy . . . . . . „ . . 25 . . 1 AlyElGayynr .. .. .. „ .. 90 I Helena Elyan . . . . . . Levantine 25 . . 1 Ahmed Mohamed . . . . . . Arab 13 1 Admed, son of Aly Elmursy .. „ ..10 Ahmed Murad . . . . . . „ . . 25 1 . . Naali'li Levi . . . . . . Jew . . 23 . . 1 Salcob Habashy . . . - . . Copt . . 40 Saved Abu Umar . . . . . . Aral) . . 35 1 J 7 3 10 July 2— Leleh Klialcefeh . . . . . . Arab 7 . . 1 Moh. Rultnn . . . . . . „ . . 25 1 Elytliamasy Leerat . . . . . . Greek . . 45 Saddika Nasif .. .. .. Arab ..3 .. 1 Ahmed Hassan . . . . . . ? . . 30 Moh. Elshcrbeeny .. .. „ ..25 1 Ilannumeh Shihata . . . . . ? , . . 4 . . 1 Hag Moh. El Naky . . . . . . „ . . 40 1 Moh. Makhallawy' .. .. . . ? ..80 1 I.nbarka Abdel Aal . . . . . . „ . . 90 . . 1 5 5 10 July 3— Moh. Kher-el-Barbary . . . . Arab . . 28 i FaJmeh Sadek .. .. .. ..9 .. 1 Khadr.i Abdelfettah . . . . „ . . 1 . . 1 Hnnna Habashy .. .. „ . Copt ..10 1 Moh. Elsamoon .. .. .. Arab ..25 1 Hassan Ismael Areeda .. „ ..10 Moh. D.iyyati, the carter . . . . ? ? 35 1 . . Ahmed Moh. Elshafhy .. ..* „ ..37 1 Yoklet Col pulo .". .. .. Greek 25 1 Sid Ahmed Soliman Nofal .. .. Arab ..: 12 1 29 Nationality. Age. Male. Female. Male. Female. Total. Fareeda Ibraheem .. .. .. Jew .. 6 .. 1 Haleema Negro . . . . . . Arab . . 30 ? 1 Giovanni Giorgio . . . . . . Greek . . 85 1 ? Azab Salim . . . . . . Arab . . 90 1 Faheemeh Sbaweesh. . . . . . „ . . 6 . . 1 Michel Girgig .. .. .. Copt ..12 1 Husxii Yousif-el- Barbary .. . Arab .. 8 1 .. Moh. Eldeeb . . . . „ . . 50 1 12 6 18 Total .. ..... 41 26 67 (Signed) The Head Doctors of the Moudirieh, Dakahlieh. Inclosure 3 in No. 20. Mr. Murdoch to Vice~Consul Borg. (Extract.) Mansourah, July 6, 1883. I BEG to inform, you that the Moudir issued circulars this afternoon calling a meeting of Consular officials and native Notables to advise them of instructions which, he had received by telegram from Cairo relative to the evasion of the Quarantine Regulations, to the effect that any person attempting to break through the cordon would be fired upon. This, it appears, is in answer to his telegram of last night regarding the attempt to pass the cordon by the Syrians, amongst whom it seems there was a Syrian doctor named Mansour Hasny. The Moudir is to issue circulars to-morrow requesting all Consular officials, to advise their subjects of this order. The death-rate has decreased a little to-day, and we hope the improvement will continue. A supply of vegetables has been allowed to enter the town to-day, but a great scarcity of meat still exists, and everything is very high in price and insufficient in quantity. On account of the great number of people at present out of employment, and consequently without means of subsistence, the Moudir asked several of the native Notables to open a subscription list and to assist the poor and indigent with food, &c. This they promised to do at once, and a call was to be made on neighbouring Sheikhs requesting them to send sheep, vegetables, &c, for the benefit of the needy. Owing to the existence of the sanitary cordon round the town, a great difficulty exists in getting goods (such as provisions, medicines that are now lying at Talha) across to Mansourah. The apothecaries here are completely run out of disinfectants, and the goods lately ordered by them have been (and are now) lying at Talha for the last seven days, and even the medicines ordered by Sidky Bey are now there, and although he went himself and communicated with the authorities at Garbieh side of the river, he failed to obtain delivery of the medicines that are now most urgently wanted here. I do not know who is responsible, but it seems impossible to work a cordon intelligently on the Talha side. No provisions have yet arrived from Alexandria, and every one complains of the want of food. I trust, therefore, that it will be arranged that such articles as provisions will be allowed to come, and that orders will be issued regarding the medicines now at Talha. The price of everything in the shape of provisions is rising fast, and in a very few days we shall be at famine prices. Inclosure 4 in No. 20. Mr. Murdoch to Vice-Consul Borg. Sir, • Mansourah, July 6, 1883. I BEG to inclose Return of cases from cholera from the commencement of the epidemic to date. 30 From a KQl'Usal Qf tb& list you will observe that the Iteturn of the 4th instant is the heavies.! of a}J, and 9,11 improvement has since taken place, which we hope will I Most of the deaths recorded these last two days are from the middle of the town, :h at first \pas free from disease, and the quarter of Mit-Hadr is now comparatively there being only one death recorded there yesterday, and thus the apparent ency of the disease is to travel southwards. **» ••₯- ijip ii 1 __i_jjt "tin I As, far as I anJL aware, no deaths from cholera have occurred at the village of a, opposite Mansourah, and I observe that the wind almost invariably blows from direction towards Mansourah. I understand that no cases of cjiolera have rred amongst aijy of the villages ; the epidemic is apparently confined to the i towns, thus suggesting defective sanitary arrangements as the cause. A 1 n m . • / i \ *1 l 1 j ' • 1 / • /V» j 1 1 1 \ 1 A number of Syrians (ten), with two women, tried (ineffectually, however) to pass the cordon last night, and were brought back by the soldiers, looking rather ashamed of tUejr fqolish eonjjupt. The Moudir admonished them, and tqld them not to attempt to do so again, or they would be imprisoned, Some of them hold good positions here, and nearly all of them are men of I am, &c. (Signed) FREDERICK T. MURDOCH. Inclpsure 5 in No. 20. ISfP£P3LN of Gases an 4 Deaths from (Cholera m the Town of Mansourah from the commenqpment; of the Epidemic (June 25), to July 5, 1883. j Number of New Cases. Number of Deaths. Europeans. Natives. j Di rec tion of Wind Eurc P« ns - Natlves - Europeans. Natives. Pate - at 4 p.m. 9am 4 Pit «• m •>' « Total Total 3 A.M. 4 p.m. . « .8 8 .8 Deaths. Deaths. 0 O June 2S ... ... 2 ... ... 1 „ 26 ... ... 7 3 4 J ... 5 : „ 27 ... ... 1 ... 1 I Moitly from ihe „ 28 ... ... 3 7 1 6 ... 7 )¦ quarter of Mit „ 29 89 U.W.... 8 10 3 6... 9 HaSr; " „ 30 ... 80 88 N., very little wind. 1 ... 7 4 1 ... 4 2 1 6 July 1 ... 78 89 N.W. 10 7 7 3 ... 10 J „ 2 ... 79 87 N.W 9 9 6 5 ... 10 ~\ Middle of town all „ 3 .. 82 88 i W 1 1 20 12 1 1 11 5 2 IB f these. Eighteen „ 4 ... 79 87 | N.W 31 20 27 16 ... 43 f deaths from new „ 8 ... 81 88 I W., strong breeze... 1 ... It 5 1 ... 19 17 1 36 J cases to-day. 4 143 Showing a total number of deaths from cholera to date of 4 Europeans and 143 natives. (Signed) FREDERICK T. MURDOCH. July 5, 1883. Inclosure 6 in No. 20. Mr, Murdoch to Vice-Consul Borg. (Extract. ) Mansourah, July 12, 1883. I HAVE pleasure in informing you that the Moudir gave Saleh Bey lyakeel, of the Sidky Bey, and Osman Effendi, town's engineer, instructions to accompany me to the present cemetery, and select a piece of land as near to the present one as possible consistent with future extension in case of need, and to avoid prpximity to any existing thoroughfare or houses. On arrival at the land immediately behind the present cemetery, we found the stench very bad, abundantly proving the urgenj; necessity for a new cemetery. We found apiece of land immediately behind the present cemetery, but entirely out of the town, and not near any Jjpu^es or rpad§, ew4 there being no crops on the land, operations are to commence to-morrow to dig out the receptacles for the dead. The land selected has an area of 5£ fedflans, and as the Coptic cemetery is in an squally bad state, and tHe Jewish and CJathblic cemeteries faeingalso full, the Moudir 31 has decided to take the entire 5f feddaus, sd that each sect may have separate lots set apart for their use, and thus avoid any religious contention. The land selected is admirably suited for the purpose, and meets with the approval of indst people who' have seen it. . I am sorry that I was unable to inclose the list of deaths for yesterday in the list; but I did not get it until too late for the post. I find the greatest number of deaths are from the centre of the town, where, on account of the narrow streets and the close proximity of the houses one to another there is very little ventilation or fresh ail*. The son of one of the principal Ulemas died to-day, and a great crowd of people attended the funeral (at least 200), and his body having been taken to the mosque of Sheikh Hassanairi, nearly all these people entered, and remained there at least an hour, till the tomb was prepared and closed up. This custom cannot fail to spread the disease to many houses that would otherwise escape, as these people came from different parts of the town ; when they dispersed, many of them would carry with them the germs of cholera into their houses, and although they may themselves escape, still any one predisposed would receive the contagion in that way. Now that the railway is open our principal wants will be supplied in a day or two, and, in fact, it is the closing of the railway that has caused all this talk about shortness of provisions. The stock of flour is exhausted, and the baker is obliged to use Arab lour, which, although riot so fine as Trieste, jstill 1 think it is quite as wholesome. A stock of flour and other provisions is expected here to-morrow. LThe price of mutton is now at its iiormal rate, and fowls, pigeons; &c; are also duced in price. I learn Mr. Goodall has buried over 400 carcases; besides a large quantity of bones, &c.', which he has had taken out of the Nile betweeli Mansburah find Da'mietta. Some day§ ago tlie Moudir suggested to some of the Notables here that lie would be glad if they would contribute something for the support of the poor and unemployed, who were at present without the means of obtaining proper food ; and also told them that every one could give in kind what lie had most of, such as grain, rice, sheep* fowls, &c. Instead of responding to his appeal in a proper manner, this Seems to have created quite a storm of opposition, and when the Moudir saw his idea was not entertained he gave it up ; the poor Arabs have therefore to make the best of matters as they ate, and borrow bread from their friends who may be better off: I have not heard of any one actually dying from starvation, but I know that the very greatest distress exists amongst the poor, and, unless relief is speedily obtained, many who may escape cholera will die of starvation. Please cause the order to be forwarded as soon as possible for the 2,000 rations. While every one's attention is at present drawn to the cholera, it is as well to draw the notice of the Minister of the Interior to the state of the Nile banks. ' There were no repairs made on them last year, and unless some one is sent to examine and report on the defective parts, and have these defects immediately remedied, the country will be in danger of an inundation. The Moudir and Wakeel are both here, and cannot get out, so that some means ought to be at once devised to carry out these necessary repairs to save us from a further misfortune — an inundation. Inclosure 7 in No. 20. Mr. Murdoch to Vice-Consul feorg. Sir, Manbouraii, JWy 14, 1883. I HAVE to inform you that the Minister of the Interior Has 1 authorized the' Moudir regarding the new cemetery, rations, &c. The order arrived late last night, arid immediately I was advised of It I sent off a tlegram to Sir E. B! Malet, informing him of its arrival ; biit the telegrafili office had osed, and it will only reach him this morning. I Regarding the food supply, we have just received a consignment of provisions at p.m. this evening, having been at Talha over thirty hours. This arrival relieves Our esent wants, and, if communication with Alexandria is kept up, we are not likely to n short again. I have liad inf attention, during the last few days, drawn to the cordon on the land side round MansoiiraK, and, as the result of the inquiries that I have made, I am prepared to substantiate the following :—: — ¦^¦yio paiyl on *iq Hfiilv £*vfi flpH \x\r n i \"\ vp*s inH I?ji*o*a nn in lipfs li ovp 1 W\ a fnnrn • 32 Kin one particular case, a native here has for several days running taken his cks out of the town to his land outside the cordon in the morning, and brought back at sunset, the operation costing him a parise (25.) per day. That a considerable number of Greeks and Syrians have succeeded in evading the Kon, and are not now in Mansourah, most of them having left by way of Simbeln, by rail to Cairo, thence to Alexandria ; and some of them now write to their Lds here from the latter place. X Under these circumstances the cordon is practically useless as a sanitary safeguard ist communication with places outside Mansourah. The work of filling up the stagnant pools is being pushed forward with dispatch, and two of the very worst are now nearly filled up, and will be completed to-morrow. The work on the cemetery is being proceeded with, and will be ready for the interment of cholera victims in two days. The deaths to-day, for twenty-four hours, are 23 males, 33 females, natives ; 1 male and 2 female Europeans ; chiefly from the south-w estern, or Mit-Talha, district of the town. Mit-Hadr is now almost free from cholera, only one case having taken place there to-day. Yesterday the Moudir made an examination of some of the houses of the Notables, and found some of their houses in a disgraceful state of filth, notwithstanding all the warnings and advice they have received ; and in two or three of the worst cases he caused the owners to be imprisoned — a punishment they well deserved, as, although the Moawins and others who are responsible for the cleansing of the houses and streets had repeatedly warned them to clean and disinfect their houses, only in few instances has a sullen kind of obedience been given to their orders, and a good many paid little or no attention to them whatever. I learn that Major Holroyd has just arrived, to erect tents and superintend the transport of goods from Talha to Mansourah, and this will doubtless facilitate greatly the entry of provisions, which is the most pressing of our wants. The cholera does not seem to be so virulent these last two days, but a great number of people complain of choleraic diarrhoea, which does not seem to go beyond that stage. The atmosphere to-day has been as if filled with dust, and quite hazy, similar to a khamseen, although there was no wind till nearly sunset. The order for rations and the new cemetery has caused, along with the opening of the railway, general satisfaction, and every one hopes, by the use of the tents, &c, to bring to an end this dire disease. I am, &c. (Signed) FREDERICK T. MURDOCH. Inclosure 8 in No. 20. Khairy Pasha to Sir E. Malet. Mon cher Ministre, Le Caire, le 12 Juillet, 1883. JE reponds imme'diatement a votre lettre de cc jour, me communiquant le te'le'gramme gui vous est parvenu hier au soil* de votre Agent Consulaire k Mansourah. Je vais e"crire a l'instant meme a son Excellence Baker Pacha pour qu'il veuille dormer les ordres necessaires au Commandant dv cordon sanitaire de Mansourah de transferer le cordon au dela dv Palais pour faire de l'emplacement aux tentes. Pour cc gui concerne les provisions je ne puis que vous remettre, ci-inclus, traduction dune depeche te'le'graphique que le Moudir de Mansourah vient de m'envoyer ; le contenu de laquelle dement completement les plaintes formule'es ace sujet. Le Gouvernement a autorise dcs le commencement de la maladie la distribution gratuite dcs rations aux pauvres ; ne"anmoins je vais en repe"ter l'ordre au Moudir. Je ferai connaitre a son Excellence Salem Pacha l'objet de la plainte pour cc gui concerne les me'decins, mais en attendant je suis en etat de vous assurer, mon cher Ministre, que hier encore trois autres me'decins indigenes ont e'te envoye's a Mansourah et qu'un medecin Europeen doit avoir e'te' de*signe aujourd'hui pour se rendre dans ladite ville. Veuillez, &c. (Signe*) KHAIRY. 33 My dear Minister, Cairo, July 12, 1883. I ANSWER at once your letter of to-day, in which you communicate to me the telegram which reached you last evening from your Consular Agent at Mansourah. XI will write at once to his Excellency Baker Pasha, so that he may give the ssary orders to the Commandant of the sanitary cordon of Mansourah for the on to be extended to outside the Palace, so as to leave a space for the tents. BAs regards provisions, I can only send you the inclosed translation of a telegram h the Mudir of Mansourah has just sent me, and of which the contents entirely •ove the complaints made on the subject. As soon as the disease showed itself, the Government authorized the distribution of free rations to the poor ; but lam about to repeat the order to the Mudir. II will inform his Excellency Salem Pasha of the object of the complaint, in as far relates to the doctors ; but, in the meantime, lamin a position to assure you yesterday three native doctors were sent to Mansourah, and that a European »r was to have been chosen to-day to go to the town in question. I have, &c. (Signed) KHAIRY. Inclosure 9 in No. 20. The Mudir of Mansourah to the Minister of the Interior. (T&egraphique.) Le 12 Juillet, 1883. ILES vivres, comme d'ordinaire, ne manquent pas. Tout cc gui est ne'eessaire consommation est fourni au fur et a mesure. Cc gui a etc rapporte qu'une c de la population de Mansourah mourrait de faim, nest pas conforme a la e\ PLa classe aisee de la population peut facilement se procurer aux memes prix que le passe les denrees et toutes les choses dont elle a besom. Une partie de la classe ouvriere et dcs individus gui avaient pour habitude de se livrer a la vente dcs articles dont l'entree est actuellement prohibee par les mesure quarantenaires, e'prouvaient certaines difficulty's a pourvoir a leurs moyens d'existence Avant meme de recevoir l'autorisation que j'avais demande par le telegraphe a votre Excellence a l'effet de fixer dcs rations a cette categoric de gens, tous nos efforts non jamais fait defaut un seul instant pour faire face a tous leurs besoms. (Translation.) (Telegraphic.) July 12, 1883. PROVISIONS, as usual, are not wanting. All that is required for food is furnished as it is needed. The report that a part of the population of Mansourah is dying of hunger is untrue. The moderately well-to-do classes of the population can easily obtain, at the same prices as hitherto, all goods and things which they need. A part of the working class, and of the persons who used to sell the articles of which the entry is now forbidden by quarantine, found some difficulty in providing the means of existence. But even before I received the permission to issue rations to people of this class, for which I telegraphed to your Excellency, our efforts never failed to meet all needs. No. 21. Consul Cookson to Earl Granville.—(Received July 25.) My Lord, Alexandria, July 16, 1883. I HAVE the honour to transmit to your Lordship herewith a despatch addressed to me by Mr. Mie*ville respecting the alleged importation of the cholera. I have, &c. (Signed) CHAS. A. COOKSON. F 34 Inclosure 1 in No. 21. Consul Mieville to Consul Cookson. (Extract.) Alexandria, July 16, 1883. IN the official " Moniteur lsgyptien " of the 7th July a letter was published, o which I have the honour to inclose a copy, in which it is suggested that the choler had been imported into Damietta by an Arab stoker named Mohamed Kbalifeh. Th letter states that on the 18th June the man left the British steamer " Timor " from Bombay at Port Said, and proceeded at once to Damietta, and insinuates that th disease must have existed on board the vessel, and that the germs were conveyed b; the said Mohamed. The refutation is contained in the man's own story, a copy of whose statement ' annex. He deposes that after leaving the " Timor," which had no sickness on boarc and had taken twenty days to come from Bombay, he remained several days in Por Said, and only reached Damietta on the 21th June, two days after cholera had declarec itself in that town. Inclosure 2 in No. 21. Extract from the "Moniteur IZgyptien" of July 7, 1883. LA lettre suivante a e'te' adresse'e au Conseil de Sant6 et d'Hygiene Publique : — " A son Excellence le Dr. Salem Pacha, President dv Conseil de Sante' et d'Hygiene Publique, Caire. " Excellence, * Port-Satd, le 5 Juillet, 1883. " J'ai l'honneur de vous accuser reception de votre lettre datee dv 29 Juin, laquelle ne m'est parvenue qu'avant-hier soir. J'y vois avcc satisfaction que l'honorable Conseil partage mes vues sur la route de l'importation de la maladie gui regne e'pidemiquement a Damiette et Mansourah. " J'ai l'honneur de communiquer a votre Excellence les re*sultats de mes investigations. "Le 18 Juin dernier, debarqua a Port-Said dv steamer Anglais 'Timor,' venant de Bombay et allant a Naples et Genes, un chauffeur nomine Mohamed Khalifa, Egyptien (natif de la Haute-Egypte), gui partit immediatement pour Damiette. J'adresse a votre Excellence la re"ponse recue aujourd'hui dv Gouverneur de Damiette a deux depeches gui lvi f urent adresse"es, sur ma demande, au sujet de Mohamed Khalifa, par son Excellence le Gouverneur-Gene'ral dv Canal. Bien que n'e*tant pas entierement satisfaisantes pour expliquer le developpement dune e'pide'mie de cholera Asiatique a Damiette, elles permettent cependant d'admettre le fait de l'importation dv mal par Mohamed Khalifa. " Peut-e"tre dcs cas chole'riques se sont-ils manifestos a bord dv ' Timor ' apres son depart de Bombay ? par consequent, le nomine* Khalifa se serait trouve\ a son arrive* e k Port-Said, dans la periode d'incubation de la maladie. N'est-il pas possible Ogalement que cet homme ait e'te' atteint de diarrhe'e cholerique en arrivant a Damiette ? "Je me propose de continuer mes investigations dcs resultats desquelles je m'empresserai de faire part a votre Excellence. " Veuillez, &c. (Signe*) "Dr. Flood." Inclosure 3 in No. 21. Interrogators subi par Mohamed Khalifa, et adrcsxe a son Excellence Hassan Pacha Mahmoud, President dv Conseil Sanitaire Maritime et Quarantenaire, par M. le Dr. Chaff ey Bey. MOHAMED KHALIFA, de la Moudirieh de Kena, age de 32 a 34 ans, a quitte depuis sept ans son pays ; il a e'te' employ 6 au commencement a Port-Said, par la Compagnie dv Canal, en qualite de chauffeur, et dernierement il est parti a bord dun "bateau Anglais dont il ne connait pas le norn, et y a rempli les fonctions de chauffenr pendant deux mois, a destination de Bombay: Le bateau a sejourne a Bombay pendant trois semaines ; le dit Mohamed Khalifa isrnora I' existence d'aucune maladie 35 limbay. Ensuite le dit bateau est parti de Bombay dans de bonnes conditions eniques, charge* de marchandises, coton et riz, et n'avait aucun passager a l'excepde son Equipage, dont tous etaient bien portants et que pendant la traversee mne n'a e'te' malade. La traversed de Bombay a Port-Said a dure* vingt jours, amed Khalifa a quitte le dit bateau pour aller a sa maison, dans laquelle il est ! quatre jours ; ensuite il s'est dispute* avec un soldat cavalier dv Gouvernement e"te" arrete* et mis en prison pour trois jours, apres lesquels ordre lvi a 6t6 donne* ;on Excellence le Gouverneur de Port-Said de quitter la ville. II est alors parti rd dun navire pour Damiette ; la traversed de Port-Said a dure* vingt heures. II reive* a Damiette Dimanche matin, le 24 Juin, 1583 ; et en descendant en ville il assis au cafe* dv nomme* Salem-el-Sandoubi; s'etant soule il fut mis en prison quelques heures ; il est reste* a Damiette jusqu'au l cr Juillet, 1883, jouissant 3 bonne sante\ BVers la fin de la journe'e dv l er Juillet, 1883, il se sentit pris de vomissements et arrhe'e le*gers, lesquelles lvi passerent le deuxieme jour. Le Lundi, 9 Juillet, 1883, nous, Soussigne"s, declarons avoir appele le nomm Mohamed Khalifa, lequel est venu a pied jusqu'a I'Office Quarantenaire, et l'avon interroge en presence de MM. le Me*decin-en-chef de la localite, le Dr. Nedin Inspecteur Sanitaire de la ville; son Excellence le Dr. Ahmed Bey Chaffey De'legue' dv Conseil Sanitaire Maritime et Quarantenaire ; Kossery, adjoint de FOffic de Damiette, et Spiridiou Basbour, Notable de la ville ; et certifions que l'interroga toire ci-dessus de*taille a 6t6 fait devant nous. (Suivent les signatures.) N.B. — Le cholera a 6te* annonce* officiellement comme ayant fait son apparition a Damiette le 22 Juin, 1883. (Translation.) Examination of Mohamed Khalifa, sent to his Excellency Dr. Hassan Pasha Mahmoud, President of the Maritime Sanitary and Quarantine Board, by Dr. Chaffey Bey. MOHAMED KHALIFA, of the Mudirieh of Kena, age from 32 to 34, left his home seven years ago. He was first employed by the Canal Company as a stoker at Port Said, and he lately went to sea on an English vessel, of which he does not know the name, and acted as stoker for two months on a journey to Bombay. The vessel remained at Bombay three weeks. The said Mohamed Khalifa does not know that there was any illness at Bombay. The ship left Bombay, all well, with a cargo of cotton and rice, but with no passengers beyond the crew, who were all well ; during the journe no one was ill. The passage from Bombay to Suez lasted twenty days. Mohamed left th vessel for his home, where he stayed four days. Then he had a dispute with mounted soldier of the Government, was arrested, and put in prison for three days after which, he was ordered by his Excellency the Governor of Port Said to leave tha town. He then left by boat for Damietta ; the passage from Port Said lasted twelv hours. He reached Damietta on the morning of Sunday, the 24th June, 1883, and on going into the town he sat down at the cafe belonging to Salem-el-Sandoubi ; havin o got drunk, he was put in prison for a few hours. He stayed at Damietta till th Ist July,lBB3, in perfect health. Towards the latter part of the day, the Ist July, 1883, he felt himself seized by vomitings and slight diarrhoea, which left him the second day. Monday, the 9th July, 1883, we, the Undersigned, declare that we called the sai( Vlohamed Khalifa before us ; he came on foot to the Quarantine Office, and we ques ioned him in the presence of the chief medical man of the place, Dr. Nedin, Sanitar nspector of the town; his Excellency Dr. Ahmed Bey Chaffey, Delegate to th' Maritime Sanitary and Quarantine Board ; Kossery, Assistant at the Damietta Office and Spiridiou Basbour, Notable of the town ; and we certify that the above examina ion took place before us. (Eollow tfre signatures.) N.B.— lt has been officially announced that the cholera appeared at Damietta on the 22nd June, 1883. (1523] 36 No. 22. Sir E. Malet to Earl Granville. — (Received July 25.) My Lord, Cairo, July 16, 1883. I HAVE the honour to inclose a copy of a letter from Salem Pasha, President of the Cairo Board of Health, giving the names and distribution of the doctors, either European or bearing European diplomas, who are on service in the infected places. I have, &c. (Signed) EDWARD B. MALET, Inclosure in No. 22. Dr. Salem to Sir E. Malet. Mon cher Sir Edward, he Caire, le 15 Juillet, 1883. JE m'empresse de satisfaire au d'sir que vous m'avez exprime* par votre billet de cc matin et de vous communiquer les noms dcs medecins Europeans ou dipl6m's d'Europe, cc gui revient au meme, au service dans les locality's infectees : — Mansourah. — Dr. Winkler, M'decin-en-chef ; Dr. Inghilardi; Dr. Dutrieux Bey, au service dv Conseil, envoy' par son Excellence Ch'rif Pacha; Dr. Sidki Bey, dipl6m' d'Europe, Inspecteur. Damiette. — Dr. de Romano; Dr. Nadim, dipl6me d'Europe; Dr. Ferrari, dv Conseil Sanitaire Maritime Quarantenaire ; Dr. Chaffey Bey, dv Conseil Sanitaire Maritime Quarantenaire, dipldme d'Europe. Port- Said. — Dr. Flood ; Dr. Hasper. Chibin-el-Com. — Dr. Ali Souchi, dipldme d'Europe; Dr. Mahmoud Moustafa, dipldme d'Europe. Samanoud. — Dr. Soubki, diplome d'Europe En dehors de ces m'decins dipl6m's le Conseil possede dans toutes ces localit's, et surtout a Damiette et Mansourah, dcs medecins capables et experiment's, gui ont traverse" plusieurs 'pid'mies chol'riques et sont par consequent h meme de preter leurs soins avec avantage. Le Conseil sait en outre qua, Mansourah il y a cinq medecins civils Europ'ens et qua Chibin-el-Com il y en a deux. Veuillez, &c. (Sign') Dr. SALEM. P.S. — Dcs cas ayant et' signal's a Guizeh le Conseil y a envoy' en dehors dv personnel normal, gui est compose pour la ville de £hiizeh dv medecin-en-chef de l'hdpital et dv medecin dv district, y a envoy' le Dr. Butta, m'decin Europ'en, assist' de deux m'decins indigenes. Dr. S. (Translation.) My dear Sir Edward, Cairo, July 15, 1883. I HASTEN to satisfy the wish expressed in your note of this morning by informing you of the names of the European doctors, or the doctors with European diplomas, which comes to the same, now serving in the infected places. Mansourah. — Dr. Winkler, head medical man ; Dr. Inghilardi ; Dr. Dutrieux Bey, in the service of the Council, sent by his Excellency Ch'rif Pasha ; Dr. Sidki Bey, who has a European diploma, Inspector. Damietta. — Dr. de Romano ; Dr. Nadim, who has a European diploma ; Dr. Ferrari, of the Sanitary and Quarantine Board ; Dr. Chaffey Bey, of the Maritime Sanitary and Quarantine Board, who has a European diploma. Port Said. — Dr. Flood ; Dr. Hasper. ShVxwel-Com. — Dr. Ali Souchi and Dr. Mahmoud Moustapha, who have European diplomas. Samanoud. — Dr. Soubki, who has a European diploma. Besides these doctors with diplomas, the Council has at each of these places, particularly Damietta and Mansourah, able and experienced medical men, who have been through several choleraic epidemics, and are therefore fitted to do useful work. 37 The Council knows that there are besides five European civil medical men at I have, &c. (Signed) Dr. SALEM. kP.S. — Cases having been notified at Gizeh, the Council has sent thither Dr. Butta, Lropean medical man, assisted by two native doctors, in addition to the usual which, for the town of Gizeh, consists of the head doctor of the hospital and the jr of the district. Dr. S. No. 23. Dr. Mackie to Earl Granville. — (Received July 25.) My Lord, Alexandria, July 17, 1883. I HAVE the honour to transmit herewith some observations on the epidemic prevailing in Egypt, and reports on the two first cases of cholera which occurred in this town. I have, &c. (Signed) J. MACKIE. Inclosure in No. 23. Memorandum. SINCE my last Eeport of the 9th instant, there has been a notable decrease in the mortality from cholera in the two villages which have suffered most severely — Damietta and Mansourah. The virulence of the disease, however, seems to continue unmitigated, if I can rely on reports which reach me from intelligent correspondents. The Board of Health at Cairo can give no information, and I am obliged in consequence to glean my information from other sources. Reports have been sent to me from both Damietta and Mansourah of cases of death in from two to three hours, in which there had been neither vomiting nor diarrhoea. This seems to have occurred so often that many inhabitants of those villages don't believe it is cholera, but some new disease. I well remember in my own experience and practice here in the cholera of 1865 many such cases. Though the number of victims in the villages first attacked has diminished anc no very severe outbreak has shown itself in any of the other villages, yet from sligh outbreaks occurring here and there, the disease shows a great tendency to spread. U to the present the route it has taken is along the Damietta branch of the Nile south wards — in the direction of traffic and prevailing wind — the only deviations from thi line of progress as yet being Port Said, Menzaleh, Chibin-el-Cum, and Alexandria and at none of those places (except, perhaps, Menzaleh) have there been more than a few cases. If this steady though slow progress continues, it is likely to find its way along the Nile to Cairo. The cases which have occurred at such places as Chibin-el- Cum and Port Said may be accounted for by persons escaping from the infected villages, but I have no authentic information. With regard to the first case which occurred in Alexandria, the circumstances are as follows : — A man left Mansourah on the 22nd June (cholera being officially declared there on the 25th), and the same day joined his family in Alexandria. His family, consisting of wife and daughter and another woman, lived in a wooden shanty, one of a number of wooden erections huddled together in a waste open space in a healthy well-aired part of the town, but the shanties having no sanitary arrangements whatever and densely crowded by washerwomen, ironing women, poor workpeople and their families. Running parallel with these shanties and separated from them by a narrow lane is a row of badly kept offensive stables or mews. Part of this open space on which there was no building was covered by fcecal matter, being used by the families living in the The woman who lived in the family was taken ill on the Ist July, and died next 38 day- the death being certified " very probably cholera." The inhabitants of these huts were at once turned out and sent on the 4th July to Gabarri to perform quarantine, amongst them being the daughter of this man. On the 10th July she was taken ill at Gabarri with vomiting and diarrhoea, stated by the Sanitary authorities to be cholerine, but in two days she was well. The man himself left for Syria a day or two after his arrival from Mansourah, and as far as is known is alive and well, having had no symptoms of diarrhoea nor cholera. The second case was that of an Abyssinian (a servant) who lived at some distance from the house where the first case happened. He was taken to the native hospital where he died. I inclose the statement of the doctor, which contains all the informa- tion they can give. The third and last case was the Austrian referred to in my last Report, who died last Sunday. He had been drinking in the evening, ate a hearty supper (chiefly sardines), went to bed, was taken ill about midnight, and died next day at 7 p.m., having had all the symptoms of cholera. The statement with regard to Mohamed Khalifa, reported by the Sanitary physician of Port Said to have probably been the means of introducing the choler from Bombay (a statement which was countenanced by the Cairo Board of Health has been disproved. An inquiry was instituted at which the following facts wer elicited. Mohamed Khalifa shipped on board an English steamer as fireman, wen to Bombay with the vessel, remained there three weeks, and returned in the vesse to Port Said — all being in perfect health, nor had he heard cholera mentioned whi] at Bombay. The voyage from Bombay to Port Said lasted twenty days. He left th vessel at Port Said and went to his house where he remained four days. After th: he was three days in prison for having engaged in a quarrel. He then left fo Damietta, where, after a passage of twenty hours, he arrived by boat on Sunda morning the 25th June, and was there in perfect health on the Ist July. It is thi shown that he arrived in Damietta in perfect health two days after cholera was declarec having left a healthy ship. A great many of the soldiers forming the cordons sanitaires have taken th disease, notwithstanding the care taken and stringent orders issued by the Englis! officers. A letter from Colonel Sartorius of the 12th instant, states : " 1 man, Damietta cordon, taken ill to-day ; 1 officer and 11 non-commissioned officers, Mansourah cordon taken ill to-day ; Talka cordon, 1 soldier ; 1 officer and 9 men, Samanoud cordon taken ill to date and two men dead; Chibin-el-Cum cordon, 4 taken ill and 2 dea< three days ago." A paragraph (presumably authentic) in the " Egyptian Gazette ' of the 14th instant, states that it was found necessary to change the position of the cordon at Samanoud. In doing so it was necessary to cross a native graveyard, where victim to the prevailing disease had recently been interred. During the one night that the sentinels remained in the cemetery, they caught the malady. The disease has now been raging in Egypt for twenty-four days in as fatal a form as the cholera of 1865, judging from the published bulletins, and with the exception of the few cases at Port Said, most if not all of which the Sanitary physician declares occurred in refugees from Damietta, the route across Egypt from Asia to Europe has been free. The origin of the outbreak at Damietta remains as obscure as ever. The Sanitary Board of Cairo has now announced almost officially its belief that the disease has been imported from Bombay. Others also express the same belief, holding the opinion that cholera invariably spreads from India, while those who are not bound by opinion, and ask for investigation and proof, are inclined to find in the unsanitary state of the country where the disease first broke out sufficient to account for an outbreak without importation. If the substance or germ necessary for the production of cholera can be produced or evolved from decaying animal matter, a local origin can easily be found at Damietta. What constitutes cholera, even in India ? The means by which it is propagated are now generally understood, but there must be a first beginning. What is it ? If it has had its first beginning in unsanitary India, why not in unsanitary Damietta, with a river flowing through it, and supplying it with water, filled with rotting carcases of animals which have died of cattle plague, 400 of which, according to authentic information, have been fished out and buried since the disease appeared. The soil around is also the best that could be for the propagation of cholera, being loosely alluvial and foecal, and the water often nearly stagnant from the inwash of the sea. Under such circumstances cholera could dwell and thrive ; the question is —could it originate ? The study of this epidemic will be epidemologically, commercially, and politically, of most intense interest, and the investigators will have to be independent men, free 39 from all political influence, if truth is to be arrived at. lam not aware that a case of cholera has occurred in Egypt since the winter of 1866. I have seen cases of choleraic diarrhoea, but none fatal. In the summer of 1881 I saw one case in a woman in this town which I thought would prove fatal, but she recovered. The Egyptian Medical and Sanitary Administration has been showing grea activity lately, and has sent doctors, medicines, and disinfectants to the infectec villages ; but sending one or two young medical men with disinfectants to disinfec an Egyptian village to stop cholera is like pouring a bucketful of water in the sea to float a stranded ship. To disinfect an Egyptian town means destroying and recon structing it ; it is impossible to cleanse and disinfect it ; and, moreover, I wil undertake to say that nine-tenths of the men sent to do the work do not themselves appreciate the meaning and use and method of disinfection. Sanitary habits anc practice which will stop the progress of a zymotic disease are yet foreign to the country and to the nature of the people. Dr. Chaffey Bey reports from Damietta thai the measures ordered are not carried out. Benevolent Societies have been formed chiefly by Europeans, to send aid to the stricken villages, and have at their expense dispatched several European doctors who expressed their readiness to go. Many European doctors here, experienced in cholera and epidemics, would gladly go to hel] the authorities by their advice, but the difficulty of returning to their work here in case of need, without undergoing a lengthened quarantine, prevents them. It would seem as if the cordons sanitaires have retarded the progress of the lisease, and they may retard it till the country is supplied with good water by the rising of the Nile ; but there are many reasons why the cordons sanitaires cannot stop ts progress. When a case, for instance, happens in a village at some distance from an nfected place, the people, or some of them, immediately take to flight, for fear o: )eing shut in, and have escaped long before a cordon can be formed. Several cases lave come before me where people have arrived here ill of fright from villages where )erhaps, during the night, some one had died suddenly, and they had fled, in terror rom supposed cholera and to escape the cordon sanitaire. To make it more effective i would be necessary to surround, not only the villages infected, but the whole district. July 17. — Since writing the above the appearance of cholera in Cairo on Sunday the 15th has been officially announced, and I regret to add that another case has happened in Alexandria. An Englishwoman, aged about 60 or 65, of rather intemperate habits, living in a low-lying, unhealthy, densely-populated quarter of the town was taken ill yesterday at 11 a.m. and died at 11 a.m. to-day. In this case, which ] visited and treated, the symptoms of cholera were not very severe, though she presentee a markedly choleraic appearance ; the urine was not suppressed and was not albuminous. She kept a lodging-house, and I was informed that several refugees from the villages had lately lodged in her house, previously to leaving for Europe or Syria Whether they came from villages where the disease actually existed or not, no one could tell me. The tendency of the disease to spread, notwithstanding cordons sanitaires, is very marked, and I am afraid there is now little hope of saving the country. It has now left the banks of the river and spread more in the direction of the chief line of railway. The cordons sanitaires are on a severe trial, and the result will prove whether they have been of any real use. If they have proved to have been a failure it is to be hoped they have had their last trial here or elsewhere, as they are the cause of great panic and much hardship, which on© would not desire to see inflicted if no good result is to be obtained. Judging the rate of progress of this outbreak by that of 1865, when nothing was done, and the development and spread were so rapid that nothing could be done, it would seem as if the cordons have retarded the progress, but that they will stem the tide completely I have no hope. The fatal nature of the malady is still its marked feature, in that it resembles real Asiatic cholera. (Signed) J. MACKIE, Surgeon to Her Majesty's Consulate, Alexandria, July 15, 1883. 40 No. 24. Earl Granville to Sir E. Malet. (Telegraphic.) Foreign Office, July 25, 1883, I p.m. ASK if medicines are required. If so, they could be taken out by doctors to-morrow. No. 25. Sir E. Malet to Earl Granville. — (Received July 25.) (Telegraphic.) Cairo, July 25, 1883, noon. THE Khedive has this morning been to the hospitals and visited the cholera wards ; he afterwards visited the Egyptian infantry, cavalry, and artillery, going round all the barracks and military hospitals, and has expressed to me his great satisfaction at the admirable arrangements made by Sir Evelyn Wood. He returns to Alexandria to-morrow. No. 26. Earl Granville to Sir E. Malet.* Sir, Foreign Office, July 26, 1883. I HAVE to request that you will consult Surgeon-Major Hunter with respect to the employment of hospital assistants from India for service in Egypt during the present cholera epidemic, and, if you have not already done so, with respect to other measures the adoption of which his Indian experience may suggest. J have to request that you will press strongly on the immediate attention of the Egyptian Government whatever measures he may advise. I have conveyed to you, by telegraph, the substance of this instruction in reply to your telegram stating that the Egyptian Government decline the offer of hospital assistants from India. I am, &c. (Signed) GRANVILLE. No. 27. Sir E. Malet to Earl Granville. — {Received July 25.) (Telegraphic.) Cairo, July 25, 1883. EGYPTIAN Government thank sincerely for offer hospital attendants from India, but will not require them.f No. 28. Earl Granville to Sir E. Malet. (Telegraphic.) Foreign Office, July 26, 1883, 4*30 p.m. WITH reference to my telegram of the 24th instant, the remaining ten doctors leave for Alexandria, via Brindisi, this evening. They are : Doctors MacNalty, Thrupp, Wyborn, Porter, Crookshank, Leslie, Wilkins, Cantlie, and Honman. They should be met by one of the Consular Staff. No. 29. Sir E. Malet to Earl Granville. — (Received by telegraph, July 26.) (Extract.) Cairo, July 26, 1883. IN reply to allegations made in certain newspapers respecting the Prefect of Police of Cairo, I have the honour to report that Osman Pasha Ghaleb is Governor of the town as well as Prefect of Police. Substance telegraphed July 25, + No. 15. 41 K'here is much conflict of opinion with regard to this high official, and I think who blame him for everything that goes wrong in the present emergency are rhat hasty in their judgment. I have, however, obtained the Khedive's permission to allow Colonel Chermside to be temporarily attached to the Prefect. Both His Highness and I have great confidence in that officer, and I trust that his knowledge of Turkish and Arabic may go far to obviate misunderstandings, which I am inclined to think are in some measure due to the communications between the English police officer and the Prefect passing through an interpreter. No. 30. Karl Granville to Sir E. Malet. ¦¦graphic.) Foreign Office, July 27, 1883, 5 p.m. IF the Egyptian Government requires doctors to be engaged here, it would ¦ell that they should be asked for as soon as possible. Should hospital assistants be sent from India ? No. 31. Earl Granville to Sir E. Malet. (Telegraphic.) Foreign Office, July 30, 1883, 2-45 p.m. WE can, if necessaiy, send more doctors on Thursday. Please answer it they are required. Has any further decision been come to about Indian assistants ? No. 32. Sir E. Malet to Earl Granville. — (Received by telegraph, July 30.) My Lord, Cairo, July 30. 1883. WITH reference- to your Lordship's telegram of the 27th instant, I have the Er to inform your Lordship that the Sanitary Board, at its meeting held this oon, has decided to accept the offer of the forty Indian hospital assistants, to be panied by a sanitary officer, as well as to ask for eight more doctors. The . however, desires that they should come from India. The above resolution has not yet been ratified by the Council of Ministers, but it probably will be to-night. I have, &c. (Signed) EDWARD B. MALET. No. 33. Earl Granville to Sir E. Malet. (Extract.) Foreign Office, July 30, 1883. 1 HAVE "to request that you will inquire and report as to the tax which is said to be levied on the carcases of animals interred, and which it is intimated may have been the cause of the condition of the neighbourhood of Damietta that led to the outbreak of cholera. This tax is stated to have been imposed in the time of the Khedive Ismail, but to have been subsequently repealed. It will, however, be necessary to inquire not merely whether the tax has been so repealed, but also whether the local authorities may not havecontinued to levy it notwithstanding the repeal. 42 No. 34. Sir E. Malet io Earl Granville. — (Received July 30.) (Extract.) Cairo, July 17, 1883. I HAVE the honour to inclose a Report addressed by Salem Pasha, President of the Board of Health, to the Khedive, respecting the cholera, and to draw your Lordship's attention to the concluding paragraphs, in which his Excellency reiterates the opinion that the disease is Asiatic cholera, and that it is imported. It is somewhat unfortunate that the President should thus early commit himself to an opinion on a subject requiring so much investigation. Inolosure in No. 34. Extract from the " Moniteur Egyptien'' of July 9, 1883. SON Excellence Salem Pacha, President dv Conseil de Sante et rie, et le Sous-Ministre dcs Travaux Publics ordonne et fait exe*cuter d'urgence i les mesures gui sont adoptees et propres a ameliorer ou assurer la salubrite ILoutes ces mesures ont arrete la marche de la maladie gui dans l'epidemie de avait en peu de jours envahi toute l'figypte, tandis que cette fois il y a deja •rze jours qu'elle a fait son apparition et elle est rested circonscrite a quelques tes. IDette maladie est bien le cholera Asiatique, ainsi que la constate la Commission r&e a Damiette et, le Rapport adresse par le Medecin Sanitaire de Port- Said ntre que les sympt6mes sont bien caracteristiques et bien ceux dv cholera |)r, la Conference Internationale de Constantinople a considere comme d^montre j cholera Asiatique envahissant ne s'est jamais ddveloppe spontan^ment et na s e'te observe a, l'etat endemique en Europe et en figypte, et qu'il est toujours dv dehors, meme au Hedjaz ou. le cholera se developpe souvent. ¦La Conference retient qu'il ne paralt pas y avoir un foyer originel mais qu'il ile y avoir e'te jusque la toujours importe dv dehors. B!es conclusions viennent confirmer l'opinion dv Conseil de Sante que le cholera a •c importe dv dehors et dcs recherches sont faites pour arriver a decouvrir son c a Damiette, et il espere qu'elles aboutiront a un bon r^sultat. No. 35. Sir E. Malet to Earl Granville. — (Received by telegraph, July 31.) Ijord, Cairo, July 31, 1883. [ HAVE the honour to inclose copies of the letter I received from the Minster Le Interior, and of the telegram I dispatched to the Viceroy of India, respecting octors and hospital assistants whose service are required in Egypt. I have, &c. (Signed) EDWARD B. MALET. Inclosure 1 in No. 35. Khairy Pasha to Sir E. Malet. Mon cher Ministre, Minister e de Vlnterieur, le 30 Juillet, 1883. B/E Conseil de Sante auquel je me suis empresse de communiquer votre lettre dv 28 courant, m'informe par sa lettre d'aujourd'hui qu'il a decide de demander uvernement de Sa Majeste Britannique I' envoi de huit autres medecins en dehors uze gui vont arriver. Re Conseil de*sirerait que ces huit medecins soient envoyes dcs Indes et non dc eterre, afin qu'ils puissent dormer une direction aux quarante hospitaliers offerts Gouvernement dcs Indes, et cc dans l'interet dv service par suite de leur le dv traitement donne aux choleriques. [1523] . G2 44 ... , 11 Quant aux assistants hospitaliers, et non aux mfirmiers, ainsi que les appelle votre Excellence, le Conseil de Sante prenant en consideration les observations verbales dv Chirurgien- General Dr. Hunter sur ieurs qualites, accepte le concours dcs quarante offerts par le (Souvernement dcs Indes a titre provisoire, ainsi que celui dv chirurgien propose. Le Conseil de Sante de*sire toutefois que ces assistants hospitaliers soient Musulraans et connaissent, si possible, l'Arabe. Veuillez, &c. (Signe) KHAIRY. (Translation.) My dear Minister, Ministry of the Interior, July 30, 1883. THE Board of Health, to whom 1 hastened to communicate your letter of the 28th instant, informed me, under to-day's date, that they have decided to ask Her Britannic Majesty's Government for eight other doctors beyond those who are now to come. The Board wish these eight doctors sent from India and not from England, so that they may be able to direct the forty hospital assistants offered by the Government of India, and also in the interests of the service, on account of their practical knowledge of the treatment required by cholera patients. As to the hospital assistants, and not the nurses as your Excellency calls them, the Board of Health, considering what Surgeon-General Hunter has said verbally as to their capabilities, accepts the assistance of forty ottered by the Government of India, provisionally, as also that of the proposed surgeon. The Board desires, however, that these hospital assistants should be Moslems, and, if possible, men knowing Arabic. I have, &c. (Signed) KHAIRY. Inclosure 2 in No. 35. Sir E. Ivlalet to the Viceroy of India. (Telegraphic.) Cairo, July SI, 1883, 9 A.M. EGYPTIAN Government now asks for the forty hospital assistants previously offered. Following requirements are specified by Dr. Hunter : — They should be Mussulmans and have passed in English, should be of each class, proportionally of third class ; caution that only those fitted for the work be sent, as failure would be disastrous. Being required chiefly for sanitary work, as many as possible should come from Sanitary Department. They should bring — 1. Specimens of all forms, civil, sanitary, and military. 2. Copy of medical code. 3. Pield medical companion, one each, contents complete. L Each to be supplied with copy of small book on sanitary work, published by Indian Government. The medical officers in charge should be selected from among Deputy Sanitary Commissioners, and be of not less than eight to ten years' service. The Egyptian Government also requests that seven other medical men be sent from India. It is desirable that they should have a knowledge of sanitary administration. Terms offered, 300/. for three months, travelling expenses and lodging. No. 36. Earl Granville to Sir E. Malet. Sir, Foreign Office, July 31, 1883. , I HAVE to acknowledge the receipt of your despatch of the 17th instant, and to state that I shall be glad to receive any further Report by Salem Pasha as to the origin of the outbreak of cholera in Egypt.* I am, &c. (Signed) GRANVILLE. 45 No. 37. Sir E. Malet to Earl Granville. — (Received August 1 .) My Lord, Cairo, July 18, 1883. WITH reference to my despatch of this clay's date,* I have the honour to inclose copies of a correspondence which has taken place between Dr. Salem Pasha, the Presidem of the Boord of Health, and Dr. Grant, Cherif Pasha, and me on the subject o asking Her Majesty's Government to lend medical assistance during the present epidemic of cholera. I have, &c. (Signed) EDWARD B. MALE! 1 . Inclosure 1 in No. 37. Dr. Salem to Dr. Grant Bey. M. le Docteur, Caire, le 17 Juillet, 1883. ESN reponse a hi communication que vous avez bien voulu me faire, j'ai honneur de informer que le Conseil de Sante et d'Hygiene Publique a etd trfcs sensible a l'inteiei rend le Gouvernement de Sa Majesty Britannique au pays et l'offie de Sir Edwarc de faire venir d'Angleterre douze medecios pour aider le Corps Medical Sanitaire les circonstances actuelles. Je crois pouvtant devoir vous faire observer que la maladie ayant deja pris une grande extension, il a etc decide de lever les cordons et le Conseil de Sante pourra ainsi utiliser dans d'autres localites les nombreux medecins gui y sont enfermes. Le Gouyernemen ayant en outre autoris^ le Conseil a engager les medecins civils exercant dans le pays a deja commence a profiter de cette autorisation, et je crois que nous pourrons pour !e moment suffire aux besoms dv service. Le Conseil de Sante accepte toutelois avec reconnaissance l'oflfre genereuse gui lvi est faite et sollicite le pouvoir, en attendant I'arrivee de ces medecins et vu la marchc rapide de la maladie, de s'adjoindre le concours dcs me'deeius de l'Armee d'Occupation, si le besom venait a s'en faire sentir. Yeuillez, &c. (Signe) Dr. SALEM. (Translation.) Sir, Cairo, July 17, 1883. E!N reply to your communication, I have the honour to inform you that the c Health and Sanitary Council fully appreciates the interest which the Governof Her Britannic Majesty take in the country, and Sir Edward. Malet's offer of c doctors to be sent from England to aid the Medical Sanitary Body. I should, however, point out that, the disease having extended greatly, it has been decided to withdraw the cordons, and that the Sanitary Council will thus be able to utilize in other places the doctors who are now shut in by them. Besides the Govern ment having authorized the Council to engage the civil doctors practising in the country, the Administration has already commenced taking advantage of this permis sion, and I think that for the moment we shall be able to meet the requirements o BThe Sanitary Council, however, accepts gratefully the generous offer, and begs until the doctors arrive, and in view of the rapid spread of the disease, it may be orized to obtain the assistance of the doctors of the Army of Occupation if it Id be found necessary. I have, &c. (Signed) Dr. SALEM. oee ±vo. o 46 Sir E. Malet to Che'rif Pasha P ue) Caire,le \BJuillet, 1883. sident dv Conseil de Saute me previent qu'il serait reconnaissant d'avoir les ouze medecins Anglais si le Gouvernement de Sa Majeste voudrait les envoycr, int leur arrivee il sollicite le concours dcs medecins de 1 Armee d Occupation si ait a s'en faire sentir. Est-ce que votre Excellence m'autorise a faire cette •res de mon Gouvernement? Je ne puis que la recommander a votre accueil (Telegraphic ) Cairo, July 18, 1883. THE President of the Sanitary Council informs me that he would be glad to have the services of twelve English doctors if Her Majesty's Government would send them and pending their arrival he asks for the assistance of the doctors of the Army of Occupation, if it should he found necessary. Does your Excellency authorize me to make this request to my Government ? I can only recommend it to your favourable consideration. Inclosure 3 in No. 37- Che'rif Pasha to Sir E. Malet. Alexandrie, le 18 Juillet, 1883. (Telegraphique.) B . ie 10 »^ 00, DU moment que le Chef de notre Service Samtaire declare que le nombre dcs medecins dont nous disposons est insuffisant, je vous serai oblige d'obtenir dv Gouvernement de Sa Majeste" l'envoi de douze me'decins. (Translation.) ('Telegraphic ) Alexandria, July 18, 1883. AS the Head of our Sanitary Service declares that the number of doctors whom we have available is insufficient, I should be obliged if you would move Her Majesty s Government to send twelve doctors. No. 38. Sir E. Malet to Earl Granville. — (Received August 1.) My Lord, Cair0 > Juh J 22 > 1883 : I HAVE the honour to inclose copies of Reports from Mr. Murdoch, Actmg British Consular Agent at Mansourah, relative to the cholera epidemic. I have, &c. (Signed) EDWARD B. MALET. Inclosure 1 in No. 38. Mr. Murdoch to Vice-Consul Borg. Mansourah, July 18, 1883. rt« t lviunsuwi uii, uuiy xo, xuotj. I BEG to inclose list of cases and deaths co date, from which you will observe that the death-rate is considerably reduced, although the great reduction on the night of the 15th to eMit gave rise to hopes that have not unfortunately been realized. Hassan Effcndi; the hospital doctor, died yesterday, and an examination of his room proved it to be in a very filthy state, with a quantity of cucumbers, Arab pickles, and dried fish lying about, showing that he had been very indiscreet in his C From a Report Dr. Spitzky has made to the Relief Committee I learn that only one of the tombs in the new cemetery is made of the regulation depth of 1A metres ; all the others are only 1 metre, and some only 50 ccntim. to 60 centim., and no earth 47 or quicklime was used ; and the brickwork being quite new, fissures occur as it dries, the result being a stench even worse than the old cemetery, if that were possible. II will represent the matter to the authorities to-morrow, and endeavour to get it medied. I am told the hospital is in a bad state ; that there is no cook to make food for the patients and no beds, and a want of medicines. My informant had visited the hospital to-day. I am, &c. (Signed) FREDERICK J. MURDOCH. Inclosure 2 in No. 38 Return of Cases and Deaths from Cholera in the Town of Mansoural), from the 11th July to the 17th July, 1883. T Fali P P r CI Th"r e " Number of New Cases. Number of Deaths. j, ate _ Direction of Wind Europeans. Natives. Europeans. Natives. Remarks. 9 A.M. 4 P.M. „• w „• „; 8 ? 3 "3 3° "i 8 "i 3 § ¦ a 1 Jj 5 3 1 o o | ! JiUy 11, 1883 83 02 W., light breeze 1 49 40 Three were sudden deaths „ 12, „ 8a 92 Ditto 2 ... ii 31 ) Middle and south-weste „ 13, „ 81 94 N.W., light breeze 3 3 1 a 23 33 } quarter*. „ 14, „ 82 94 No wind 1 1 4 25 !S2 Sky hazy-likc. „ 16, , 84 96 N.W., light breeze 18 8 ... 4 30 27 ¦) Khamseen. No wind till au „ 16, „ 84 97 Ditto 9 5 1 2 17 18 > set. Middle and south-we „ 17, ? feO 95 Ditto 1 1 1 20 21 ) quarter*. Mitlladrnon 6 10 208 205 Natives ... ... ... ... ... ... ... ... ... 413 Europeans ... ... ... ... ... ... ... ... ... 15 Total ... ... ... ... ... ... ... 428 (Signed) FREDERICK J. MURDOCH, Acting Consular Agent. Inclosure 3 in No. 38. Mr. Murdoch to Vice-Consul Borg (Extract.) Mansourah, July 20, 1883. REGARDING the tents, I am sorry to say that they are not appreciated as I was led to believe they would be. When a death occurs in a house the parties living in it are all sent to live in the tents until the house is properly disinfected and fumigated, and if they have means of subsistence they are allowed to return to their house, if not they must remain in the tent. tThe tents were also to be used by those who have no friends or houses here, ese objects have all been frustrated for want of soldiers to prevent those in the tents communicating with the town and vice versd. I have communicated with the authorities on the subject, who admit their inability to prevent the communication, and they have placed watchmen on to form a sort of cordon, but they do not hold out much hope of its being successful and they ask for some soldiers. ¦understand an order has been received from Salem Pasha to the effect that all ents must take place in the new cemetery. A most disgraceful occurrence took place at the new cemetery on Wednesday last. It appears that the servant of Hassan Effendi (a Barbary) died the same day as his master, and when the two bodies wero brought to the cemetery it was found that the tomb intended for the doctor was not quite finished, and the parties who brought the bodies put them both into a newly-finislied one belonging to Sheikh Ibrahim Abou Hegasd and built or sealed up the entrance. Shortly afterwards Hegazi, becoming aware of what had been done, immediately destroyed the tomb and, 48 Id tiie bodies out, leaving them on the ground until they were taken by some le who had witnessed the scene and buried m another tomb. I have requested luthorities to inquire into the matter, and if the accusation against Hegazi is founded to award him severe punishment as an example to others. As an instance of the worthlessness of the cordon as a means of preventing communication I beg to draw your attention to the following : — Yesterday afternoon a number of Arabs were sitting in a field about half way between the town and the cordon, and I received notice that they had a considerable quantity of goods with them, and were waiting till after sunset to pass through the cordon. I sent my clerk to examine the goods and, if possible, ascertain where they He was told they were going to Mehallet Damane, and the goods consisted of one box containing two tins petroleum, a quantity of calico, oil, &c, and four persons were to pass through, although there were six at that place. They passed through without difficulty. The death-rate is gradually decreasing : twenty-five natives and two Europeans in twenty-four hours. No. 31). Sir E. Malet to Earl Granville. — (Received August 1.) My Lord, Cairo, July 22, 1883. I HAVE made a fresh representation to the Minister of the Interior respecting the burials of cholera victims in Cairo, and 1 have the honour to inclose copy of his Excellency's reply on the subject. I have, &c. (Signed) EDWARD B. MALET. Inclosure in No. 39. Khairy Pasha to Sir E. Malet. Mon cher Ministre, Caire, le 21 Juillet, 1883. EN reponse a la lettre que vous avez bien voulu m'adresser au sujet dcs nouvelles gui sont donnees par les journaux, je m'empresse de vous communiquer les renseignements suivants, gui rn'ont etc fournis par le Conseil de Sante et d'Hygiene Publique. Les vetements dcs personnes gui meurent dans les h6pitaux et dans leurs habitations sont immediatement detruits. Quant aux enterrements et au transport dcs morts, ils se font selon les usages religieux dv pays ; c'est-^-dire, le mort subi trois lavages, au moms, a l'eau chaude savonneuse, le corps est enveloppe dans un cerceuil neuf contenant dv camphre en poudre, et dcs matieres aromatiques, et cela d'accord avec les preceptes religieux dv pays. Le transport dcs cadavres se fait comme k Fordinaire dans dcs cerceuils en bois gui sont soigneusement desinfectes apres l'inhumation. (SignS) KHAIRY. (Translation.) My dear Minister, Cairo, July 21, 1883. IN reply to your letter about the news published in the papers, I hasten to give you the information furnished to me by the Public Health and Sanitary Board. The clothes of those who die in the hospitals and in their own homes are immediately destroyed. As to the burial and carriage of the dead, these matters are conducted in accordance with the religious customs of the country ; that is, the dead body is washed three times, at least, in warm soap and water, and is wrapped in a new winding-sheet, with powdered camphor and aromatic substances, as laid down in the religious prescriptions of the country. 49 after the interment. (Signed) KHAIRY. No. 40. Earl Granville to Sir E. Malet. (Telegraphic.) Foreign Office, August 1, 1883, 25 P.M. WHAT is law as to burial of cattle ? Is there still a tax, or has it been repealed ? No. 41. Sir E* Malet to Earl Granville. — {Received August 1 .) ¦graphic.) Cairo, August 1, 1883, 5-45 P.M. YOUR telegram of tc-day. The tax on the burial of cattle was repealed more than two years ago by Riaz Pasha. When, at the beginning of the epidemic, it was asserted that the casting of the dead Binto the canals was owing to this tax, a Circular was issued warning the local rities against levying it. No. 42. Consul Cookson to Earl Granville. — {Received August 2.) My Lord, Alexandria, July 22, 1883. I HAVE the honour to transmit to your Lordship herewith a despatch addressed Bi by Mr. Mieville, inclosing a preliminary Report from two Sanitary Doctors at etta on the course of the cholera epidemic at that place. I have, &c. (Signed) CHAS. A. COOKSON. Inclosure 1 in No. 42. Consul Mie'ville to Consul Cookson. I HAVE the honour to forward herewith copy of a preliminary Report on the outbreak of cholera at Damietta, addressed to the President of the Maritime and Quarantine Sanitary Board by "Dr. Eerrari, the Director of the Sanitary Office at Damietta, and Dr. Ohaffey Bey, the special Delegate sent by the Board to study the disease and endeavour to trace its origin. Both these gentlemen have had a large experience of cholera both in the pilgrim encampments in the Red Sea and at the Holy Places of the Hedjaz, and confidence may be placed in their observations. Kb is hoped that the full Report from Drs. Chaff ey Bey and Ferrari will soon be oming, and I shall, Sir, when it arrives, endeavour to obtain an early copy for lission to you. I have, &c. (Signed) W. E. MIEVILLE, British Delegate. Inclosure 2 in No. 42. Dr. Ferrari and Dr. Chaff ey to Dr. Hassan. Excellence, Esbeh, le 12 Juillet, 1883. NOUS avons l'honneur de vous accuser reception de votre lettre dv 15 Juillet courant, par laquelle vous nous demandez de vous envoyer, deux fois par semaine, un [1523] H 50 Rapport collectif sur la marche, les caracteres de la maladie, ainsi que toutes les observations que nous pourrions faire. En response nous avons l'honneur de vous informer que l'e'pide'mie dv cholera gui a sevi a, Damiette depuis le 22 Juin avait suivi une marche ascendante jusqu'au l er Juillet, jour ou elle a atteint le point le plus culminant, comme vous aviez dv l'apercevoir par les bulletins journaliers gui vous sont envoyes regulierement, ainsi que par les elats gui vous ont et6 adresses jusqu'au 10 courant. Dans sa marche ascendante, la maladie a presente dcs caracteres franchement attaquant les personnes sans distinction ni d'age, ni de sexe, ni de race ; toutefois sans avoir atteint jusqu'ici aucun Europeen, foudroyant parfois les attaque's, mais en guerissant aussi quelquefois sans aucune medication, souvent guerissant par le moindre soin, et tres souvent resistant a. tout traitement. Dans ses attaques, la diarrhe'e est le symptomc predominant dans le tableau cholerique ; les vomissements s'y associent sans persistence ; les phenomenes algides ne sont pas intenses ; les crampes aussi s'observent moms souvent. Mais depuis le l er Juillet la maladie, apres etre restee quelques jours a l'etat stationnaire, a suivi sa course descendante ; e'est alors que les cas sont devenus plus benins, moms foudroyants, cedant plus souvent au traitement. Mais la periode de reparation a presente alors les caracteres incomplets et irreguliers, et nous avons observe le passage a l'etat typhoide. A cette date l'epidemie est en ddcroissance tres sensible, comme vous le prouve toujours le bulletin de la mortality, que nous avons expedie bier au soil* a votre Excellence. Les attaques sont devenues rares dans la ville, mais il s'en fait encore dans les environs. Dans la courbe que la maladie a suivi il nous est impossible, et a gui que cc soifc hors de nous, de savoir et de dire quel etait le nombre dcs attaques par rapport au chiffre de la mortalite journaliere. L'epidemie dans sa marcbe a presente plusieurs oscillations plus ou moms sensibles en augmentation ou diminution. Nous avons remarqu6 que les joumees calmes et chaudes favorisaient sa marche, tandis que les journees fraiches et ventileuses etaient toujours suivies dune diminution de mortalite. Mais la chose la plus digne de remarque e'est, comme vous le verrez dans notre Rapport general traitant dcs causes de la naissance de l'epidemie, la coincidence mathematique, et presque miraculeuse, de l'abaissement rapidc dc l'epidemie avec l'arrive'e dcs eaux premieres de la crue dv Nil a Damiette. Quant au fait de l'individu mort en deux heures la semaine derniere, sans avoir eu ni diarrhee ni vomissement, la mort a eu lieu au milieu dun acces convulsif, et le inedecin en a pose la diagnostique " eclampsie," comme vous en avcz etc informe dans une derniere correspondance. Quant aux mesures gui ont et& jusqu'ici prises, nous nous voyons obliges de vous repeter qu'elles ne consistent, jusqu'a present, qu'en la presence de quatre medecins, un phamacien, et une sage-femme, gui est arrivee avant-hier seulement. Le service de salubrite de la ville n'a jamais etc organise, car, en dehors dun service fictice de balayage et d'arrosage dans quelques points principaux de la ville, il existe actuellement nes grands enclos en ruine, combles de grands monceaux d'immondices. C'est avec beaucoup de peine que nous avons obtenu de tapisser les rues de la ville avec dv sable sec ; les quartiers populeux et populaciers de la ville n'ont jamais e"te evacues. On nous avait un peu ecoutes pour clover les latrines dcs mosquees et dcs bains publics, apres avoir bien etc desinfectees ; mais cette mesure a (Ste* prise pour qitelquesunes seulement, tandis que, actuellement, nous voyons exister, non seulement de grands egouts deversant la riviere, mais aussi Ton constate l'existence de puits pleins de maticres fecales. Cc grand depdt est habituellement cure par dcs machines elevatoircs ("sakie") pareilles a celles dont on se sert a la campagne pour arroser les champs. Les enterrements continuent a se faire dans les cimetieres sises au centre de la ville. Enfin, malgre cet de choses, nous constatons, grace a Dieu, que l'epidemie parnit toucher a sa fin a Damiette. Le present llapport nest, dv reste, qu'un extrait dv Rapport general que nous sommes en train de rediger relativement a la naissance de la maladie, et gui forme le veritable objet de notre mission a Damiette. Quant aux renseignements que votre Excellence nous demande sur l'etat sanitaire dcs bestiaux a Damiette et ses environs, nous croyons que le typhus bovin continue a re"gner toujours dans ces localites, attendu que M. le Dr. Eerrari a constate de visu, en 51 ¦Nous nous permettons de prier votre Excellence de nous faire savoir si c'est cet nble de renseignements que vous desirez que nous vous envoy ons deux fois par me, en quel cas nous nous empressons d'en r^diger d'autres. En attendant, &c. Le Directeur, (Signe) Dr. G. PERRARI. Le Dele'gue' dv Conseil a Damiette, (Sign 6) Dr. A. CHAEEEY. (Translation.) Excellency, . Esbeh, July 12, 1883. WE have the honour to acknowledge the receipt of your letter of the 15th July, asking us to send you twice a-week a general Report on the progress and the character of the disease, as well as any observations we niight have to make. I In reply, we have the honour to inform you that the cholera epidemic* which has 1 at Damietta since the 22nd June, increased until the Ist July, when it reached ighest point, as you will have seen from the daily bulletins which are regularly to you, as well as from the Tables which have been sent to you for the period i the 10th instant. ¦ As it increased, the disease was markedly epidemic, attacking all, without distinction of age, sex, or race ; it has not, however, as yet, attacked any European ; it sometimes kills almost instantaneously ; at others, the sufferer recovers without the aid of any medical treatment, often with the least care ; but very often the disease ¦Diarrhoea is the predominating symptom with persons attacked by the cholera ; ting is also noticed, but it is not persistent ; the phenomenon of algidity is not marked ; cramps also are less often to be noticed than is usually the case. But since the Ist July the disease decreased, after remaining some days stationary; cases thenceforward, became milder, were less sudden, and yielded oftener to treatment. But recovery then became incomplete and irregular, and we noticed cases which passed into the typhoid stage. The epidemic is now sensibly diminishing, as shown by the record of deaths sent to your Excellency yesterday evening. Attacks are now rare in the town, but still occur in the neighbourhood. In tracing the course pursued by the disease, it is impossible for us and for anybody else to know and to say in what proportion the number of attacks stands to the number of deaths per diem. The epidemic has shown during its course several more or less sensible undulations of augmentation and diminution. We noticed that calm hot days increased its virulence, while the mortality fell after fresh windy weather. But the fact most worthy of remark is, as you will see in our general Report on the causes of the outbreak of the epidemic, the mathematically precise and almost miraculous coincidence of the rapid fall of the epidemic with the arrival at Damietta of the first waters of the rising Nile. Eitli regard to the individual who died in two hours last week without either 3a or vomiting, death took place during a convulsive fit ; and the doctor states se to be " eclampsis," as you were informed in recent correspondence. As to the measures as yet taken, we are obliged to repeat that they do not go beyond the presence of four doctors, one chemist, and one midwife, who did not arrive till the day before yesterday. The sanitary service of, jjhg .,.t.ow,n. has never been organized, for although there is a perfunctory sweeping and watering in the few principal parts of the town, there are still large inclosures of ruins, filled with great heaps of refuse. We had great difficulty in getting dry sand spread over the streets of the town ; the populous and poor parts of the town have never been evacuated. We were listened to so far as inducing the people to nail up the latrines of the mosques and public baths after disinfecting them, but this was done at a few only, whilst at the present moment, not only do we see large sewers emptying themselves into the river, but actually find wells which are full of foecal matter. These receptacles are emptied by elevators (" sakieh ") similar to those used in the country for watering the fields. (15231 H 2 52 Interments still take place in cemeteries in the midst of the town. ¦But, notwithstanding this state of things, we hope that the end of the epidemic amietta is, thank God, approaching. The present Report is, however, nothing more than an extract from the general Report which we are drawing up on the outbreak of the disease, and which is the real object of our mission to Damietta. With respect to the information asked for by your Excellency as to the health of the cattle at and near Damietta, we are of opinion that bovine typhus is still very prevalent in this locality ; for Dr. Ferrari himself saw an ox which was just dying, besides two carcases recently thrown into the river. W T e venture to ask your Excellency to let us know if the Reports we send you twice a- week contain the body of information which you wish ; if they do, we will continue to send them. We are, &c. (Signed) Dr. G. FERRARI, Director. Dr. A. CHAFFEY, Delegate of the Board of Damietta. No. 43. Consul Cookson to Earl Granville. — (Received August 2.) My Lord, Alexandria, July 23, 1883. I HAVE the honour to forward to your Lordship herewith a despatch addressed to me by Mr. Mieville, inclosing a Table showing the general mortality at Damietta from the 20th June to the 18th July. I have, &c. (Signed) CHAS. A. COOKSON. Inclosure 1 in No. 43. Consul Mieville to Consul Cookson. Sir, Alexandria, July 23, 18S3. I AM now able to inclose a Table showing the general mortality of Damietta from the 20th June to the 18th July, and giving much fuller, though, I regret to say, still meagre information. From this Return, which is compiled from the most authentic information obtainable, it appears that the total mortality averaged sixtynine a day, as aganst an average of four in normal times. The grand total of the deaths for the whole period — twenty-nine clays — is 1,999, of which 1,830 were from cholera, and 169 from other diseases, the whole being equally divided as between males and females, while as regards nationality the total is made up as follows : — natives, 1,988 ; Syrians, 8 : Greeks, 2 ; Russians, 1 ; so that it may be said that the cholera did not attack the European classes at all. I have, &c. (Signed) W. F. MIfiVILLE, British Delegate. 53 Inciosure 2 in No. 43. Table snowing the General Mortality at Damietta from June 20 to July 18, 1883. — — — — ¦—^— — — — _^-^_ ___ __ __^_ _ _ ____ _ __ _ __ bb^ a^ _^ _ __ ______ ___ _______ _____ _ ___ _ ______r__________-________» Locality. Status. Nationality. Sex. Total. Date. Grand Males. T . , Females. T . , From „ Total. Town. Suburbs. Rich. Poor. Egyptians. Syrians. Greeks. Russians. , °, „ , Ordinary r ? m bJt J Males. Females. n . J Cholera. Adults. Children. Adults. Children. diseases. 1883 " ~ June 20.. .. 4 .... 4 4 ........ 2 2 1 1 2 4 4 " 21 1 .. ? 1 1 .. .. .... 11 .. .. 1 1 " 22 " 13 1 1 13 14 ...... 2 4 6 3 5 8 14 14 » 23.. 21 2 1 22 22 1 .... 4 2 6 12 5 17 .. 23 23 » 24 •• 24 1 2 23 25 ...... 4 8 12 8 5 13 10 15 25 » 25.. •• 38 4 4 38 42 .. .. .. 12 6 18 13 11 24 10 32 42 » 26.. 45 2 4 43 47 .. .. .. 7 19 26 10 11 21 10 37 47 » 27 •• .. 125 4 3 126 129 .. .. .. 31 38 69 30 30 60 16 113 129 »> 28 •• •• 103 3 4 102 106 .. .. .. 22 39 61 22 23 45 5 101* 106 « 29 -« •• U6 6 3 119 122 .. .. .. 27 37 64 37 21 58 9 113 122 » 30 •• •• 104 10 4 113 114 .. .. .. 34 28 62 32 20 52 4 110 114 J^y 1 .. .. 131 14 2 143 145 .. .. .. 36 36 72 40 33 73 4 141 145 » !«• •• 129 9 4 134 138 .. .. .. 32 37 69 29 40 69 8 130 138 »» 3.. .. 106 9 2 113 114 1 .. .. 28 27 50 44 21 65 3 112 115 » 4.. .. 105 10 4 111 112 2 .. 1 38 29 67 33 15 48 4 111 115 « 5 •? •• 98 13 .. 11l 111 .. .. .. 28 20 48 40 23 63 2 109 111 « 6.. .. 94 18 2 110 110 2 .. .. 31 22 53 38 21 59 5 107 112 » 7" •• 70 27 .. 97 97 .. .. .. 28 23 51 25 21 46 5 92 97 n 8.. .. 66 28 1 93 94 .. .. .. 20 24 44 28 22 50 6 88 94 „ 9.. •• 48 13 1 60 60 .. 1 .. 15 14 29 19 13 32 9 52 61 „ 10.. .. 49 13 .. 62 62 .. .. .. 11. 16 27 20 15 35 10 52 62 „ 11 •• •• 53 15 3 65 67 .. 1 .. 22 18 40 19 9 28 . 4 64 68 „ 12.. .. 28 14 2 40 41 1 .. .. 10 14 24 14 4 18 2 40 42 ? 13.. .. 27 19 2 44 46 .. .. .. 8 13 21 16 9 25 8 38 46 „ 14.. .. 24 19 1 42 42 1 .... 9 6 15 17 11 23 5 38 43 m 15.. .. 31 11 .. 42 42 .. .. .. 10 9 19 11 12 23 7 35 42 .. 16.. .. 21 15 .. 36 36 .. .... 7 9 16 15 5 20 8 28 36 „ 17 .. .. 15 9 .. 24 24 ...... 6 7 13 7 4 11 6 18 24 „ 18.. .. 9 12 .. 21 21 ...... 7 5 12 5 4 9 4 17 21 Total .. 1,698 301 47 1,952 1,988 8 2 1 484 513 997 588 414 1,002 169 1,830 1,999 54 No. 44. Consul Cookson to Earl Granville. — (Received August 2.) My Lord, Alexandria, July 23, 1 883. I HAVE the honour to forward to your Lordship herewith a despatch addressed to me by Mr. Mieville, inclosing further correspondence respecting the alleged importation of cholera into Egypt by a fireman of the British steamer " Timor." I have, &c. (Signed) CHAS. A. COOKSON. Enclosure 1 in No. 44. Consul Miecille to Consul Cookson. Sir, Alexandria, July 23, 1883. WITH reference to the alleged importation of cholera into Egypt by Mohamec Khalifa, a fireman of the sfeam-ship " Timor,"* I have the honour to forward herewith copy of a letter from Dr. Mood, which was published in the official " Moniteur " of tl 20th July, and in the first part of which an endeavour is made to reconcile th apparent discrepancies between Dr. Flood's first account and the man's own statemen by asserting that Mohamed Khalifa left for Damietta on the 18th June, when h first disembarked, but returned to Port Said and again repaired to Damietta on th 23rd June. From the annexed letter addressed to the President of the Maritime and Quarantine Sanitary Board by the Governor of Port Said, this theory seems untenable, as his Excellency the Governor states clearly that the fireman in question did not leave Port Said for Damietta until the 23rd June, and, having left, had not returned to that place up to the 9th instant, the date of his letter. I have, &c. (Signed) W. F. MIEVILLE, British Delegate. Inclosure 2 in No. 44. Extract from the "Moniteur Egyptien" of July 20, 1883. LA lettre suivante a etc adresse"e par M. le Dr. Flood a son Excellence Salem Pacha :— "Excellence, "Port Said, le 10 Juillet, 1883. " Comme suite a ma lettre datee dv 5 Juillet courant, j'ai l'honneur de pre venir votre Excellence, quo Ton eherche a, etablir que le nomme Mohamed Halif nest parti d'ici que le 18 Chaban (correspondant au 28 Juin) se rendant a Damiette ayant etc expulse de cette ville (Port-Said) par ordre de son Excellence le Gouverneur General a cette date. II est certain qu'il est parti d'ici pour Damiette le 23 Juin mais cela n'empeche pas qu'il est parti d'ici pour la meme destination aussi 1 18 Juin, aussitAt son debarquement dv steamer 'Timor;' il est alors revenu d Damiette le 21 Juin, a commis ici quelque delit pour lequel il a etc expulse et es retourne a Damiette. De cc gui precede, votre Excellence deduira certainement qu ma premiere supposition dc l'importation dv cholera a Damiette par Mohamed Halif (gui, au reste, a change son norn, le vrai noin de cet individu etant Halil Omar) es to u jours admissible. "Quant a l'importation dv cholera et son developpement a Port-Said, il ny a aucun doute que les premiers cas aient frappe dcs personnes gui revenaient de la foir de Damiette. Le premier cas (lequel, a, cause dcs narrations mensongeres dcs parents est passe inapercu ct fut constate comme cause par maladie) etait un jeune homme Age dc 15 ans, revenu de Damiette depuis quelques jours, decede le 23 Juin ; son pere fut atteint le 30 Juin et mourut le lendemain; sa mere f ut atteinte le 4 Juillet c mourut ttpres quelques heures tie maladie. En tout j'ai constate onze cas de cholera dont huit suivis de niort ; le premier fut constate lc 25 Juin, le dernier le 3 Juillet au matin; dcs huit cas suivis de niort, j'ai visite les quatre plusieurs fois pendant la vie et ces quatre (tant avant qu'apres la mort) presentaient tous les sympt6m.es caracte * Sec Inclosurc 2 in No. 21. 55 ristiques dv vrai cholera Asiatique ; les autres quatre n'ont etc visite"s qu'apres la mort (sans autopsie, operation que les circonstances me faisaient considerer comme imprudent de faire). Dcs trois cas non suivis de mort, un jeune homme de 20 ans passait de la periode algide dans, la periode typhoide et est aujourd'liui en etat de convalescence ; les deux autres, femmes de 22 a 26 ans, je considere comme cas de cholerine (sans algidite), et elles sont aujourd'liui queries. Ayant constate que tous ceux gui etaient attaques de cholera appartenaient a quatre families, je faisais evacuer lcurs quatre habitations, lesquelles furent blai chics, desinfectees et fermees, tandis que les individus survivants, sept en nombre, furent installes dans une dcs barraques de notre lazaret provisoire, oii ils resteront isoles pendant douze jours. Cette mesure prise, je n'ai plus eu a constatcr aucun nouveau cas de cholera depuis sept jours. "Je dois attribuer la lenteur dv developpement de la maladie dans notre vill principalement aux conditions atmospheriques extremcment favorables, depuis un vingtaine de jours : le vent dv nord-ouest, gui souffle constamment, la basse tempt rature (entre 24 et 29 degre"s cent.), la secheresse de l'atmosphere. Aussi les condition hygieniques de Port-Said sont-elles bonnes, et comparativement a cellos de l'interieu celles de notre village ne sont pas mauvaises. Jose aussi declarer que le zele c l'activite deployes tant par les autorites que par les particuliers pour Fassainissemen de la ville entrent pour une bonne part dans les heureux re'sultats obtenus jusqu'a c v Veuillez, &c. M Le Medecin Sanitaire, (Signe) "De. FLOOD." (Translation.) ¦THE following letter has been addressed by Dr. Flood to his Excellency Salem a.a '. " Excellency, " Port Said, July 10, 1883. "In continuation of my letter of the sth July, I have the honour to war your Excellency that attempts are being made to show that the man Mohamec Halifa did not leave here till the 18th Shaban (28th June) for Damietta, having bee expelled from this town (Port Said) on that day by order of his Excellency th Governor-General. It is certain that he left this place for Damietta on th 23rd June, but that does not prevent his having left here for that town on th 18th June as well, immediately after disembarking from the ' Timor ;' he then returned from Damietta on the 21st June, committed some offence for which he wa expelled, and returned to Damietta. Your Excellency will certainly conclude from the above that my first supposition that cholera had been imported at Damietta by Mohamed Halifa (who, moreover, has changed his name, for he is really called Hal: Omar) is still admissible. " With regard to the importation of cholera and its spread at Port Said, there is no doubt but that the first cases were persons coming back from the fair at Damietta. The first case (which owing to the untruths put forward by the parents passed unnoticed, and was registered as death from disease) was that of a young man, 15 years old, who died on the 23rd June, a few days after his return from Damietta ; his father was attacked on the 30th June, and died next day ; his mother was attacked on the 4th July, and died in a few hours. In all I have ascertained that there were eleven cases of cholera, of which eight were fatal ; the first was on the 25th June, the last on the 3rd July in the morning ; of the eight fatal cases, I visited four several times during life, and these four (both before and after death) showed all the characteristic symptoms of real Asiatic cholera; the others were only seen after death (without post-mortem examination, an operation which, owing to the circumstances of the case, I considered it imprudent to perform). Of the three non-fatal cases, a young man of 20 was already passing from the state of algidity to that of typhus, but is now convalescent; the two others, women of from 22 to 26, I consider cases of cholerine (without algidity) ; they are now cured. Having ascertained that all those attacked by cholera belonged to four families, I had their four houses emptied, whitewashed, disinfected, and shut up, while the survivors, seven in number, were put up in one of the sheds of our provisional lazaretto, where they will remain isolated for twelve days. For seven days after these measures I had no further case of cholera to record. BI attribute the slow spread of the sickness in our town principally to the able condition of the atmosphere for the last twenty days, a continuous northwest 56 wind, low temperature (between 24 and 29 degrees centigrade), and a dry air. Moreover, the sanitary condition of Port Said is good, and compared with those of the Bior, the condition of our villages is not bad. Further, I do not hesitate to say the zeal and activity shown both by the officials and by private individuals in oving the sanitary state of the town have a good deal to do with the favourable of affairs which has hitherto prevailed. " I have, &c. (Signed) "Dfi. ELOOD, Sanitary Doctor.'* Inclosure 3 in No. 44. The Governor of Port Said to Dr. Hassan. Le 19 Jidllet, 1883. J'AI l'honneur de porter a votre connaissance, qu'il re*sulte dcs recherches faites au sujet de Mohamed Khalifa, chauffeur, qu'il e*tait parti de Port-Said pour Bombay, le 25 Avril, 1883, a bord dun bateau Anglais nomine* "Timor," gui a quitte Bombay a destination de Port-Said, le jour dv 31 Mai, 1883, et est arrive a Port-Said le jour dv 19 Juin, 1883. Le dit chauffeur a debarque* a Port-Said, et s'est rendu a son domicile, puis est parti pour Damiette, le 23 Juin, 1883, et nest plus revenu. Le chef dcs chauffeurs a declare que le dit Mohamed Khalifa ne s'est pas rendu a Damiette avant son dernier voyage. (Signe") Le Gouverneur de Port-Said. (Translation.) July 19, 1883. I HAVE the honour to bring to your knowledge that it appears from investigations made with regard to Mohamed Khalifa, a stoker, that the said individual left Port Said for Bombay on the 25th April, 1883, on board an English ship called the " Timor," which left Bombay for Port Said on the 31st May, 1883, and reached Port Said on the 19th June, 1883. The said stoker landed at Port Said and went to his home, then left for Damietta on the 23rd June, 1883, and has not returned. The head stoker declared that the said Mohamed Khalifa did not go to Damietta before his last voyage. (Signed) The Governor of Port Said. No. 45. Sir E. Malet to Earl Granville. — (Received August 8.) My Lord, Cairo, July 24, 1883. I HAVE the honour to inclose an extract from a letter which I have received from Dr. Mackie with regard to the cholera. He forwards to me a telegram from Dr. Dutrieux, copy of which is likewise inclosed. I have, &c. Signed) EDWARD B. MALET. Inclosure 1 in No. 45. Dr. Mackie to Sir E. Malet. (Extract.) Alexandria, July 21, 1883. I BEG to forward, for your information, a telegram which I received this afternoon from Dr. Dutrieux Bey, who was sent to Mansourah by the Government about a week ago, to give his aid in the infected district. The co-existence of cases of typhoid fever (typhus abdominalis) with cholera which it mentions is no new observation, and nothing to be wondered at according to modern views of the causation of zymotic disease. I am not sure that Dr. Dutrieux has ever had experience in a cholera epidemic ; lam rather of opinion that he has not. 57 Irould be no wonder, then, if with only a few days' experience he may have been ed by the typhoid state often occurring in convalescence from cholera during an emic, and called cholera-typhoid. Dr. Dutrieux has been a great traveller, and is in of trained observation, but may not have had experience in this disease. I Dr. Haddad, who was sent to Mansourah by the Relief Committee a few days re Dr. Dutrieux, had experience of cholera in Syria. I have had several tnunications from him, and he mentions only cholera-typhoid. I With regard to the part of Dr. Dutrieux' telegram where he asserts that the disease lad a local origin, I would remark that although it may appear exceedingly probable possible, it is hardly to be asserted after only a few days study ; but his evidence to corroborate what is unfortunately notorious, the extraordinarily unsanitary ition of that part of the country. II have suggested that if the cordons for the villages are to be of any use r ought at once to encircle a considerable district, and not single villages only, as moment cholera breaks out in a village many of the inhabitants, to avoid being risoned by the cordon, made their escape to some other village in the district re the authorities had time to encircle the affected village. With regard to isolation of houses or buildings in which a case of cholera has happened, I would beg to submit to you the great hardship in many such cases. I will cite as example a case which happened in this town. Mrs. J was taken ill and presented symptoms of cholera ; as soon as it became known in the building, a large one full of lodging-houses, the whole of the inhabitants fled to the street for fear of being imprisoned for ten days by a cordon. Mrs. J ,an old woman, was hourly becoming worse, and was left alone with no one to look after her. The neighbours were not afraid of cholera ; several of them offered to remain and nurse her if they had a guarantee from the authorities that they would not be shut up for an indefinite period after. Some of them were clerks in offices, others were actors and actresses in a neighbouring theatre, and stated that they had families to support, and could not, and would not, stay to be shut up from their work, and their only means of livelihood. The Sanitary authorities came and isolated the house, but had no nurse to put in charge of the poor woman, and none could be found. The consequence was that it was judged best to remove her to hospital, which she resisted with what strength and consciousness she had left, and there was in consequence considerable trouble and difficulty in removing her, which was at last accomplished twelve hours after the onset of the disease. She died in the Deaconesses' Hospital twelve hours after her arrival there. What I wish to point out with regard to such cases is that if . the Sanitary authorities are to continue to practise isolation for houses and buildings in which a case of cholera occurs, they ought to have ready a staff of male and female nurses, to be able to put a nurse in charge of the patient, to remain in the isolated building in cases where the patients have no family to nurse them, as in the case I have cited. In many such cases I believe that transporting them roughly, or a long distance to a hospital, would deprive them of all chance of recovery. This certainly does not seem right. It is true that one, several even, may have to be sacrificed to save the many but there is no reason why any should be sacrificed unnecessarily, and if the Sanitary authorities are to carry out this system they ought to provide for the patients to be cared for and nursed in cases where their state is such that they would be deprived o all chance of recovery by removal (often a very long distance, and often during the night to a cholera hospital. I need hardly mention that the removal is practised, and always will be practised in a very rough way. That there are cases which must be removed to hospital I admit — cases in which the only chance of recovery lies in being removec from their own filthy, pestilential dwellings. I intend to bring this to the notice of the Executive Council of the Sanitary Commission here, and if you agree with me as to the necessity of the Sanitary Boarc providing at once a staff of nurses for cases which ought to be treated withou removal, I shall feel obliged by your giving it your support. As I referred to the hardships of cordons in my last Report to Earl Granville, I shall be glad if you wil forward a copy of this with your despatches. ****** [1523] 58 Inclosure 2 in No. 45. Dr. Dutrieux to Dr. Mackie. (Telesjraphique.) Mansourah, July 21, 1883, 5 p.m. MES observations dans plusieurs localites infecte'es mont revile l'apparition simultanee ct Texistence typhus abdominal et cas choleriques. J'ai menie constate forme morbide intermediaire avec taches patechiales. Consid^re" e*pidemie regnant comme cholera local spontane dv a causes locales. Comme typhus existant, crois k parentee entre ces deux maladies. Suis convaincu observations ulterieures d£montreront clairement. Causes locales frappent quiconque parcourt Basse-Egypte tellement intenses que comprends pas qu'elles n'occasionnent pas epidemic meurtriere. Seraient capables d'engendrer peste ; car crois e'pide'mie a forme plusieurs foyers multiples meme avant constatation officielle Damiette. Cc fait est notoire pour quiconque receuille informations impartiales dans villages Sgypte. Pouvez communiquer Londres ; important e"claircissement ; opinion egaree. (Translation.) (Telegraphic.) Mansourah, July 21, 1883, 5 P.M. MY observations in several infected localities have revealed to me the simultaneous appearance and the existence of abdominal typhus and cholera cases. I have even ascertained the existence of an intermediate morbid form with petechial spots. Consider prevailing epidemic local spontaneous cholera, due to local causes. As typhus existing, believe in relationship between these two diseases ; am convinced ulterior observations will show it clearly. Local causes strike any one travelling in Lower Egypt as so intense that do not understand that should not produce deadly epidemic. Might produce plague ; for think epidemic formed several multiple foci before officially reported Damietta. This fact obvious to any one collecting unbiassed information in Egyptian villages. May send London; important information; opinion had got wrong. No. 46. Sir E. Malet to Earl Granville. — {Received August 8.) My Lord, Cairo, July 24, 1883. I HAVE the honour to inclose copy of a letter from Cherif Pasha, communi- eating to me the decision of the Council of Ministers, by which Generals Stephenson, Wood, and Baker, as also the Prefect of Police of Cairo, are invited to join His Highness' Ministers in an Extraordinary Commission to take steps for coping with the cholera epidemic. I have, &c. (Signed) EDWARD B. MALET. Inclosure 1 in No. 46. Cherif Pasha to Sir E. Malet. Mon cher Ministre, Caire, le 23 Juillet, J 883. J'AI l'honneur de vous transmettre ci-jointe une copie de la decision prise par le Conseil dcs Ministresi dans sa stance d'aujourd'hui au sujet de la Commission Supe"rieure Extraordinaire, institute a l'effet de combattre l'epidemie. ,Te vous prie, M. le Ministre, de vouloir bien communiqner cette decision an Ge"ne"ral Stephenson, Commandant-en-chef de l'Arm^e d'Occupation, et le prier ele vouloir bien prendre part aux travaux de la Commission. Veuillez, &c. (Signe) CHfiRIF. (Translation.) My dear Minister, Cairo, July 23, 1883. I HAVE the honour to inclose copy of a Eesolution passed by the Council of Ministers at their meeting this day respecting the Extraordinary Superior Committee established to cope with the epidemic. 59 mander-in-chief of the Army of Occupation, and to request him to take part in the I am, &c. (Signed) CHfiRIP. Inclosure 2 in No. 46. Decision of the Council of Ministers, dated July 31, 1883. CONSIDftItANT que depuis Papparition de Pe*pidemie au Caire, les Ministres presents en cette ville se re"unissaient tous les soirs chez son Excellence le Ministre de l'Tnterieur, pour arreter et prescrire les mesures ne"cessaires de concert avec le Conseil de Sant6 et d'Hygiene Publique, a l'effet de combattre le fleau ; Conside'rant que la presence au Caire dune grande partie de l'Arm^e d'Occupation rend utile et ne"cessaire la participation dv Gene'ral-in-chef de cette arme'e aux travaux de cette reunion ; kQue la meme consideration s'applique au G^n^ral Sirdar de l'arine'e figyptienne, refet de Police dv Caire, President de la Commission Spe'ciale Sanitaire, et au iral Commandant-en-chef de la Gendarmerie et de la Police, Estime qu'il y a lieu d'inviter General Stephenson, Commandant-en-chef de l'Armee d'Occupation, a, youloir bien prendre part, ainsi que le General Sir Evelyn Wood, Sirdar de l'arme'e Egyptienne, le Prefet de Police dv Cairo, et le General Baker Pacha, Commandant-en-chef de la Gendarmerie et de la Police, aux travaux de la reunion dcs Ministres, laquelle prendra le norn de " Commission Sup^rieure Extraordinaire " aux effets ci-dessus, et dont les decisions seront executes par les soins dv Ministre de l'lnte'rieur. Pour copie conf orme : Le Secretaire dv Conseil dcs Ministres, (Signe") M. Kahil. (Translation.) WHEKEAS the Ministers in town have, since the appearance of the epidemic at Cairo, been in the habit of meeting every evening at the house of his Excellency the Minister of the Interior for the purpose of settling and ordering, in concert with the Public Health and Sanitary Board, the measures necessary for coping with the scourge ; Whereas the fact that a great part of the Army of Occupation is at Cairo would make the presence of the General-in-chief of that army useful and necessary at these meetings ; Whereas the same is the case with regard to the General Sirdar of the Egyptian Army, the Prefect of Police of Cairo, the President of the Special Sanitary Committee, and the General Commanding-in-chief the Constabulary and the Police, Is of opinion that General Stephenson, Commander-in-chief of the Army of Occupation, should be asked, together with General Sir Evelyn Wood, Sirdar of the Egyptian Army, the Prefect of Police of Cairo, and General Baker Pasha, Commanderin-chief of the Constabulary and Police, to take part in the meetings of the Ministers, which will be known as the Superior Extraordinary Committee, and the decisions of which will be executed under the supervision of the Minister of the Interior. True copy, (Signed) M. Kahil, Secretary of the Council of Ministers. No. 47. Sir E. Malet to Earl Granville. — (Received August 8.) My Lord, Cairo, July 25, 1883. I HAVE the honour to state that the Viceroy of India, having telegraphed to me on the 22nd that forty Mahommedan hospital assistants were ready to start from India if required by the Egyptian Government, I informed Khairy Pasha, the Minister of the Interior, of the offer; and I have now the honour to inclose copy of the reply which I 60 have received from his Excellency, thanking the Marquis of Ripon for his kindness, and explaining the reasons for declining it. I have, &c. (Signed) EDWARD B. MALET. In closure in No. 47. Khairy Pasha to Sir E. Malet. M. le Ministre, Le Caire, le 24 Juillet, 1883. JE me suis erapresse de souraettre au Conseil de Sante' et d'Hygiene Publique la bienveillante proposition que son Excellence le Vice-Roi dcs Indes a daigne* de faire au Gouvernement figyptien par votre entremise. Le Conseil de Sante est tres sensible a l'offre, mais il considere toutefois ne pouvoir l'accepter, car il est d'avis que les quarante infirmiers dont il est question arriveraient en jEgypte trop tard, alors que l'epidemie sera dans sa pleine decroissance. Le Conseil precite" ayant, en outre, etc autorise a engager sur place les infirmiers, en possede actuellement un nombre plus que suffisant. C'est done avec les sentiments de la plus sincere reconnaissance que je decline l'offre de son Excellence le Vice-Roi dcs Indes, tout en vous priant, M. le Ministre, de vouloir bien lvi faire parvenir ces expressions. Veuillez, &c. (Le Ministre de l'lnterieur), (Signe) KHAIRY. (Translation.) Sir, Cairo, July 24, 1883 I LOST no time in submitting to the Public Health and Sanitary Board the kind offer made by his Excellency the Viceroy of India, through you, to the Egyptian Government. The Sanitary Board fully appreciate the offer, but cannot accept it, as they are of opinion that the forty hospital assistants in question would arrive in Egypt too late — when the epidemic would be rapidly dying out. The said Council, moreover, having been authorized to engage hospital assistants here, has at this moment a greater number than are wanted. It is therefore with the sincerest thanks that I decline the offer of his Excellency the Viceroy of India, and at the same time ask you to convey to him the expression thereof. I am, &c. (Signed) KHAIRY, Minister of the Interior. No. 48. Sir E. Malet to Earl Granville. — (Received August 8.) My Lord, Cairo, July 26, 1883. I HAVE the honour to inclose a further letter from Dr. Mood, published in the " Moniteur figyptien," stating that Mohammed Halifa went to Damietta on the 18th June and returned to Port Said on the 2 1 st. The inclosed despatch from Consul Burrell shows clearly, first, that the " Timor " only reached Port Said on the afternoon of the 19th June; and secondly, that Mohammed Halifa could not have reached Damietta till the 24th or 25th. I have, &c. (Signed) EDWARD B. MALET. Inclosure 1 in No. 48. Extract from the " Moniteur Egyptien " of July 20, 1883. [See Inclosure 2 in No. 44.] 61 Inclosure 2 in No. 48. Consul Burrell to Sir E. Malet Sir, Port Said, July 24, 1883. I HAVE the honour to state, in reply to your despatch of the 22nd instant, asking me to read a Report of Dr. Flood in the " Moniteur figyptien," and to inform you if there is any foundation for the statement contained in it that Mohamed Halifa went to Damietta on the 18th June and returned to Port Said, that, so far as I have been able to ascertain, there is no foundation whatever for such a ¦The Sheikh of the firemen here again assures me that Mohamed Halifa did not s Port Said to go to Damietta, or any other place, between the 18th and 22nd ¦Moreover, Mohamed Halifa only arrived here on the 19th June, and did not leave Said until sent away by the Governor ; the " Timor," the ship on which he was Lan, having reached Port Said on the 19th June at 4*12 p.m. BThe letter of the Governor to Joyce Bey, the Captain of the Port, which states he is sending away Mohamed Halifa on account of his bad conduct, is dated the June, and on that day, or the next, Halifa went to Damietta for the first timo his arrival at Port Said. It would take a whole day to get to Damietta. I have, &c. (Signed) W. PALFREY BURRELL. No. 49. Sir E. Malet to Earl Granville. — (Received August 9.) (Telegraphic.) Cairo, August 8, 1883, 7*30 p.m. SURGEON-GENERAL HUNTER leaves to-morrow on a tour of inspection in Lower Egypt. He will be accompanied by Major Mac Donald, Mr. Gibson, and Mr. Cameron, and be absent three or four days. The Government has placed a special train at his service for the whole journey. No. 50. Mr. Cookson to Earl Granville. — (Received August 11.) (Telegraphic.) Alexandria, August 11, 1883. I THE day before yesterday, owing to opposition of the Arab population to manner terment ordered by the Executive Sanitary Commission, some slight disturbances place in town, in one of which an European employe of the Sanitary Commission severely handled by the mob. At a meeting held yesterday arrangements were 3by the Sanitary Commission to conciliate this opposition ; but at 6*30 p.m., in squence of further excitement attending the disinfection of the house of Arab an supposed to have been taken to one of the ambulance hospitals near Eort )leon, a crowd of several hundred natives destroyed by stones a part of the alance. Police, with assistance of English military patrol in the neighbourhood* srsed the mob and order was restored in a short time. All quiet to-day. No. 51. Sir E. Malet to Earl Granville. — (Received August 14.) My Lord, Cairo, August 3, 1883. II HAVE the honour to report to your Lordship that the twelve doctors sent out England at the request of the Egyptian Government have arrived. Two, at the c of the Minister of the Interior, remain at Alexandria, and the rest are now here. 62 They will be under the orders of Dr. Salem Pasha, President of the Sanitary Board, but Surgeon- General Hunter will have the control of their employment. I have, &o. (Signed) EDWARD B. MALET. No. 52. Sir E. Malet to Earl Granville. — {Received August 14.) My Lord, Cairo, August 5, 1883. I HAVE the honour to inclose herewith a despatch addressed to me by Mr. Vice- Consul Borg, dated the 4th instant, reporting on the epidemic of cholera ai Cairo. I have, &c. (Signed) EDWARD B. MALET. Inclosure 1 in No. 52. Vice- Consul Borg to Sir E. Malet. (Extract.) Cairo, August 4, 1883. I HAVE the honour to report that the epidemic which, during the latter third of the month of June, broke out at Damietta, after ravaging Mansourah and other villages in the Delta, made its appearance at Ghizeh, and, on the 15th ultimo, appeared at Boulak, from which it spread through every quarter of the capital. The disease, which the Medical Commissions sent to Damietta have declared to be " Asiatic cholera " of the epidemic type, is thought by the sanitary authorities to have been carried almost simultaneously to Ghizeh and Boulak by refugees from the Menzaleh district before it could be surrounded by a sanitary cordon. The hygienic conditions of Ghizeh and Boulak being extremely favourable to the development of the germs of disease, whether on account of accumulated filth in the streets and habitations or from the dirty habits of the inhabitants, the propagation has been rapidly effected, and funerals being then allowed to go through every quarter of the town, the dead being carried in coffins of the slightest descriptions, covered with shawls afterwards worn by relatives of the deceased, the infection has been carried in every direction. As early as the sth July the Consular Body at Cairo, in view of the probability of an invasion, asked to be constituted into a Special Sanitary Commission, to adopt such measures in conjunction with the Board of Health as might be deemed necessary to minimize the effects of the epidemic at Cairo. Much, of course, remains to be done ; but I feel convinced that whatever may appear necessary will be carried out, as, by tacit understanding, national and personal jealousies have been sunk into the predominant thoughts oi minimizing the effects of the epidemic, and of affording as much relief as possible to suffering humanity. lam glad to be able to report that the English and other gentlemen whom I have appointed members of Sub-Committees vie with each other in the discharge of their arduous duties. The Returns herein inclosed for the two weeks ended the 28th July show 761 deaths from cholera in the first and 2,4:i8 in the second week. These figures do not compare favourably with those officially given for the epidemic of 1865, which stood at 205 for the first and 1,919 for the second week. The figures 'given in these Returns do not agree with those of the daily bulletins issued by the Board of Health, the former being framed for the twenty-four hours ending at 8 p.m. and the latter for periods ending at 8 a.m. I have every reason to believe that the figures given in these Returns correctly represent the number of deaths on every day, as, through the kindness of the Sanitary Inspector, I am allowed access to the original Returns sent to him from every quarter of the town from which these are framed. It will be observed that the quarters which have suffered most during the two weeks are Boulak and Old Cairo. It should be borne in mind, however, that the standing nuisances in the town proper— such as narrowness of streets, want of proper ventilation in many quarters and habitations, bad and insufficient or complete absence of drains, and the low, dirty, filthy habits of the natives — are even more intensified among the inhabitants of Boulak and Old Cairo. In these two quarters almost all the low classes live in mud-built hovels, seldom measuring above 8 feet by 8 feet, and 63 about 6 feet high, having one or perhaps two small apertures through which an uncertain light fights its way in broad noonday, and through which a small quantity of vitiated air is with difficulty let out. In these mean hovels, or rather dens of misery and squalor, usually built close together in rows facing each other at distances of about 6 to 8 feet, families of five, six, or even more persons live for the most part in common with their poultry, sheep, or other cattle ! The disease broke out among the wretched inhabitants of these places, and in the two weeks 1,00-1 paid with their lives at Boulak and 497 at Old Cairo. I Of English families living at J3oulak I am sorry to report that two persons hay Bred and in the same family, the first fatal case occurring on the 20th and th nd on the 28th ultimo. The second death, I fear, is mainly due to the fact tha house had not been properly disinfected, and that efficient measures had not bee in to minimize the dangers to which all the members of the family were exposec the Maltese community living at Boulak under circumstances which, from I tary point of view, leave very much to be desired, I am glad to be able to repor , to my knowledge, four only have fallen victims to the epidemic during the tw is above mentioned. §The accompanying Return of population for the several quarters of Cairo will that the deaths from cholera during the two weeks have amounted to 29"86 per ) for Boulak and 24*14 per 1,000 for Old Cairo, while on the total population the is have been 8*73 per 1,000. II annex, for such scientific purposes as may be required, a comparative Table of hs at Cairo from all causes during the prevalence of cholera. The mean average of deaths during eleven months in the year is 45 per diem, while during the th of Ramadan (this year the month of July) it generally rises to about 52 per i owing to the abuses committed during the hours of the night generally by the lie and lower classes. It will be observed from the said Table that the comparison he second week, the figures for the first not being given, shows a diminution of upon the corresponding week in 1865. It should be borne in mind, moreover, the month of Ramadan in 1865 corresponded to about the month of March. ¦I inclose a Table of meteorological observations for the two Aveeks and for the ssponding period in 1865. The mean average barometrical pressure has been as ws : — 1883. 1865. First week .. .. .. .. 75350 755-28 Second week . . ? ? . . 753 ¦68 756 ' Mean average . . . . 753-59 755 • 64 The mean average temperature has been :—: — 1883. 1865. Centigrade. Centigrade. First week .. .. ... .. 29*6 .29-2 Second week.. .. ? .. 30*7 28*7 Mean average .. .. 30 1 29" The hygrometer has given the following mean average results 1883. 1865. First week .. .. .. .. 46-76 33*35 Second week.. .. .. .. 42* 33 41-33 Mean average .. .. 44 54 39 84 The prevailing winds in the first week this year have been north-east and north, against south-wes.t, north-west, and west in 1865. In the second week, also northeast and north this year, against west and south-west in 1865. east and north this year, 64 j. regret jl nave noi succeecieci m outcti iiing, ror me purpose or comparison, ft Table of the rise of the Nile in 1865, and I give, therefore, one for this year only. I am glad to be able to say that the epidemic seems to have entered the stage of decrease, and I hope I may soon have the satisfaction to report that the scourge has completely disappeared. Having myself gone through two cholera epidemics, I beg, before concluding this despatch, to be allowed to place on record, for what they may be worth, two observations made by myself as well as by others. 1. In 1855 and 1865, about a fortnight before the outbreak of cholera, sparrows and other birds took their flight from the towns which became afterwards infected, and did not again appear until the epidemic had almost ceased. Some keener observers assure me that flies and mosquitos were not visible during the prevalence of the epidemics. On the present occasion, even while the disease was on the increase, sparrows were and are to be seen as usual, and are heard chirruping their gay notes, while flies and mosquitos are, if possible, a greater nuisance than ever. The absence of birds during cholera epidemics — according to the "Zoological Garden," a newspaper published at Frankfort-on-the-Main — has also been observed in 1848 at St. Petersburgh and at Riga, in 1849 in "Western Prussia, in 1850 at Hanover, in 1872 at Przemysl in Galicia, and also at Nuremberg and Munich. 2. When cholera was at its height, in the early part of July 1865, the sky was lead-coloured, the atmosphere oppressive so as to render breathing rather difficult at times, and the town of Cairo seemed to be enveloped in a spherical cloud of thick mist; whereas, thus far, we have enjoyed a pure azure sky and a comparatively light atmosphere. I trust I may be pardoned if, through a pressure of general official work, in which I could not be assisted by any one of my very limited staff, and owing to the time required and the difficulty experienced in obtaining some particulars, as also through illness in my family, I have not been able to make this Report as early as I desired. Inclosure 2 in No. 52. Population of Cairo per Census taken on May 4, 1882. Population. Quarter. Males. Females. Total. Abbasiyah .. .. .. .. 7,109 6,594 13,703 Abdin .. .. .. .. .. 13,185 14,421 27.606 Boulak .. .. .. .. .. 25,011 25,351 50,362 Bab-c4-Chariyah .. .. .. .. 20,658 21,286 41,944 Ohoubrnh .. .. .. .. 5,199 5,951 • 11,150 Darb-el-Ahmar .. .. .. .. 14,304 15,224 29,528 Ezbekiyah .. .. .. .. 28,798 30,001 58,799 Ghenialiyah .. .. .. .. 15,479 14,269 29,748 Kbalifah .. .. ... .. 17,758 18,957 36,715 Mouskee .. .. .. .. 5,711 6,495 12,206 Old Cairo .. .. .. .. 10,918 9,664 20,582 SayyedaZenab .. .. .. .. 15,897 18,253 34,150 Grand totals .. .. .. 180,027 186,466 366,493 65 Inclosure 3 in No. 52. Comparative Table of Deaths at Cairo during the Prevalence of Cholera. 1883. 1865. n 4 From Other , r . , -^ . From Other m *_| Date. ,-., , /, lotal. Date. «i i /-« lotal. Cholera. Causes. Cholera. Causes. July 15 .. 3 74 77 June 21 .. 2 ?16 .. 3 88 91 ?22 .. 2 ?17 .. 46 80 126 ?23 .. 3 ?18 .. 69 75 144 ?24 .. 17 „ 19 .. 11l 83 194 „ 25 .. 25 ?20 .. 186 66 252 ?26 .. 71 ?21 .. 347 70 417 ?27 .. 85 ?22 .. 401 60 461 ?28 .. 93 75 168 ?23 .. 405 57 46J ?29 .. 136 65 201 ?24 .. 405 70 475 ?30 .. 2i6 84 300 „ 25 , .. 332 64 396 July 1 .. 329 77 406 ?26 .. 292 80 372 ?2 .. 306 90 396 ?27 .. 290 69 359 ?3 .. 382 112 494 „ 28 .. 313 71 384 ?4 .. 457 84 541 X 66 Inclosure 4 in No. 52. Meteorological Observations at Cairo during the prevalence of Cholera. 1883. 1865. IcorreSToT'temp. Thermometer (Centigrade). Hygrometer. Ozonometer. Direction of Wind. correrted^V JcSJSg Hygrometer. ""wEE * Date _ Mean (0 to 21) Nilometer. Date. tem P* Mean , Average. 1 p.m. — ¦ Average. 7 a.m. 1 p.m. 7 p.m. 7 a.m. 1 p.m. 7 p.m. 7 a.m. 1 p.m. 7 p.m. Sunrise. 2 p.m. Sunrise. 2 p.m. Sunrise. 2 p.m. Pics, kirats. JnW l<4 754-18 753-17 752*27 23*7 342 342 4833 7* N.E. N. N. 8 22 June 21 756" 756- 294 31-2 40- S.W. W. 16 75437 75251 751 65 23*7 342 334 46- 4- N.E. N. N. 9 5 22 755' 755- 302 32- 40" S.W. S.W. 17 75235 75110 749*66 252 32*7 352 46*66 5' N.E. N. N. 9 7 23 756- 756' 28-3 303 40- W. W. 18 752-22 75214 75175 255 352 32 8 47*66 4" N.N.W. N.W. N. 9 9 24 754- 752- 27-2 31-2 40- N.W. W. 19 755-33 75533 754*59 23*2 322 30-5 4533 5* N.E. N. N. 9 10 25 755' 755- 263 30-5 37' N.W W. 20 756-58 75579 754*91 21-7 307 31*2 42*66 4* N.E. N. N. 9 13 26 754- 756* 262 304 35* S.W. S.W. 21 755-73 754*61 753*18 22*2 30* 292 50*66 4' N.E. N.E. N. 9 15 27 756* 758* 24*4 32* 36*5 N.W. N.W. 22 754*05 754*24 753-60 23*2 32-2 31*7 4C*33 3* N. N.E. N. 9 17 28 757* 759* 23*8 314 37' N.W. S.W. 23 753-97 753*50 75320 22-7 34*5 331 43* 4 * N.E. N.W. N.E. 9 19 29 756" 756* 24*6 324 38- W. W. 24 754-78 752*60 753-34 23' 36*2 35*2 43* 6- N. N.E. N. 9 22 30 756- 756* 265 323 39-8 S.W. S.W. 25 754*53 753*25 751*81 24*2 35 7 34*2 36*66 8' N.E. N.E. N. 10 3 July 1 756' 756* 255 3*\s 49*5 W. S.W. 26 756*58 758*48 755-28 24*2 34*7 33*2 40*66 6* N.E. N.E. N. 10 11 2 755* 755* 26*4 32* 40T. W. S.W. 27 752*98 751*25 751*25 24*2 352 35-2 4333 6' N.E. N.E. N. 10 21 3 756* 756* 242 32-4 415 ¦ N.W. W-28 753-33 75294 752-30 24*7 34*4 332 43-33 6' N.E. N.E. N. 11 9 4 755- 755* 25-4 33- 43" W. S.W. 67 Inclosuxe 5 in No. 52. Return of Deaths from Cholera at Cairo duriug the Week ended July 21, 1883. (Twenty-four hours, ending at 8 p.m.) *"J July 15. July 16. July 17. July 18. July 19. July 20. July 21. Totals. » J&L. ¦"»*—¦ anX". *»»«-• Ztoll. Europeans. Jft™ Europeans, "»»»—¦ J&gL Europeans. J,^. E^opeans. JJgj^ Europeans. u~" u ~" Quarten. _^____ ,„ , ¦ . ¦¦ ¦ ¦¦¦ i ¦¦ . . . . ___^____ , ________ . S.S.S.S S.S.S.S.S 5 3 S S S S S ____ __________ Abbaslyah „ „ 12 12 Abd ee>i ... ._ 1 1 1 3 1 ... .„ 3 3 !_ '.'.\ 8 10 "i _ 15 15 1 3 Bab-el-Charlyah 1._325| __ j • ' 5 . Boul»k 3 .' 1 2 ... 20 18 ... ... 28 27 88 41 ... 1 62 58 „. 1 94 112 ... ... 246 258 ... 2 Choubrah 2 _ 4 1 13 10 „. ... 17 13 Darb-el-Ahmar . .... 1 _ _ „, 1 2 Ezbeklvah _, 247411 3 !" 11 'l 9 '.'.'. '." 21 "*37 '"- Gliemallvah _ „ 1 Khalifa " _. ~" " _„ "* _, '"i "l **" |" Mouskee „ " ._ __. ... ." |" \¦ J 1 Old Cairo „ 5 1 1 2 2 ... „. 8 3 15 IS 2« 29 Sayyeda Zenab 1 ... 1 1 1 ... ... 2 1 4 3 — Hospital .„ 6 7 3 18 1 11 4 ... 4_ 8 (Totals „ 3 1 2 21 24 1 38 31 -•"•^ 56 54 ... 1 103 80 2 1 168 | 181 1~ 2* 38s" 372 8™" 5 Grand totals ._ 175 152 14 J] 147 13» ~T" 3 t Rm" 148 <** , L 15 ° 7 ' 2 J }' m ' IIK U ~*~~, Grand totali ... ... ' 401 ' 406 '[ 405 332 292 "290 35 2,438 X 2 68 No. 63. Sir E. Malet to Earl Granville. — (Received August 14.) My Lord, Cairo, August 6, 1883. I HAVE the honour to inclose the statistics, compiled by a local newspaper, from the official Returns of deaths from cholera up to the morning of the 31st ultimo. The mortality in Damietta, Mansourah, and Shibin-el-Kom has been considerable ; the last-named place, which has only 16,000 inhabitants, is put at 1,000 deaths, and still continues to contribute several each day to swell the total. ESome of the large towns, such as Damanhour, Tantah, Zagazig, and Rosetta, have y recently been attacked, and will, I fear, suffer heavily before any diminution can expected. The epidemic has also lately taken hold of several places in Upper ypt, but the Fayoum has hitherto escaped. "With regard to the statements in the newspapers as to the unreliable nature of the Returns, it is hardly to be supposed that they are very correct, and for various reasons, especially in the smaller villages, the full totals have, in all probability, not been officially recorded ; but, on the other hand, there is no reason to believe that there has been any attempt on the part of the authorities to suppress the truth in this icoptX/li. EThe epidemic appears to have followed the eastern branch of the Nile from delta, and it is only quite lately that the western, or Rosetta branch, has been affected. During the last few days, however, the town of Rosetta has begun to yield its victims, and even the places to the west of it, such as Damanhour and Kafr-Dowar, now regularly contribute to the bulletin. Up till now Alexandria has escaped with a few isolated cases, but a great danger exists in the fact that the villages on the Mahmoudieh Canal, by which the town is supplied with water, have recently had cases of cholera. I have also the honour to forward to your Lordship a Table of the deaths in the several quarters of Cairo from the first outbreak up to this morning. Your Lordship will observe that Boulak and Old Cairo, which are on the Nile, have been much more seriously stricken than the rest of the capital; the village of Ghizeh, about 2 miles off, on the other bank of the river, has also lost upwards of 800 people, a very large mortality for so small a place. So that it may be concluded that the epidemic has come to us from the river, the inhabitants along its banks having been the principal sufterers. It is remarkable lioav little the rest of Cairo has been attacked. Mr. Borg shows in his Report that, whereas the mortality in Boulak and Old Cairo, up to the 28th ultimo, was 2986 and 2414 per thousand, the rest of the town had lost only 8*73 per thousand ; and your Lordship will see that the six quarters furthest from the river, which contain a total of 163,844 persons, within a very limited area, have none of them had more than twenty deaths on any single day since the first outbreak. The remaining districts, I am told, have suffered chiefly in the portions of them which adjoin Boulak, Old Cairo, and the banks of the river. I have the honour to inclose a map of Cairo, on which the districts are marked, with their populations, as stated by Mr. Borg."' I have, &c. (Signed) EDWARD B. MALET. 69 Enclosure 1 in No. 53. Tableau Recapitulatif de la Mortalite depuis le D6but de l'fipid&nie jusqu'au 31 Juillet au matin. V'illl'C. a s9 « # •• •• 0,t70t) Bouiacq . . . . . . 1,576 Vieux Caire . . . . 650 Choubra .. .. .. 194 Saida Zenab .. .. 179 Khalifa .. .. .. 139 Abdin ? .. .. 369 Ezbekieh . . . . . . 227 Bab-el-Charieh .. .. 196 Hopital .. .. .. 205 Musky . . . . . . 58 Darb-el-Ahmar . . . . 62 Gamaliel] . . . . . . 36 Abassieh . . . . . . 74 Armee d'Occupation . . 20 Armee d'Occupation (Inte'rieur) . . . . 29 Damiette .. .. .. .. 1,898 Mansourah .. .. .. .. 1,071 Chibin-el-Com.. .. .. .. 1,015 Ghizch .. .. .. .. 687 Mahalleh el-Kebir . . . . . . 484 Samanoud . . . . . . . . 347 Gallioubieh (Province de) . . . . 280 Tantah .. .. .. .. 263 Menzaleh .. .. .. .. 248 Zifta.. .. .. .. .. 141 Mit-el-Gamar .. .. .. .. 124 Chirbin .. .. .. .. 120 Chobar .. .. .. .. 100 Zagazig . . . . . • ? • 62 Talka .. .. .. .. 60 Benba .. .. .. .. 60 Simbelhawin . . . . . . • • 58 Menoufieh (Province de) . . . . 55 Barrage . . . . . . . • 50 Tela.. .. .. .. .. 41 Minieh .. .. .. .. 31 Bemba .. .. .. .. 29 Rosette .. .. .. .. 28 Charkieh (Province de) . . . . . . 29 Sofia.. .. .. .. .. 27 Embabeh . . . . . . . . 26 Dagadoure . . . . . . . . 24 Belkas .. .. .. .. 21 Ismailia . . . . . . . . 20 Belbeis .. .. .. .. 17 Kafr-el-Zayat .. .. .. .. 17 Merael Rhoda .. .. .. ». 17 Alexandrie . . . . . . . . 16 Tourah .. .. .. .. 16 KafrCheikh .. .. .. .. 15 Port-Said .. .. ? .. 12 Boher .. . . , » .. 12 Magaga ? . . . . . . 10 Beni-Souef . . . . . . . . 7 Touck .. .. .. .. 6 Kabaiiat . . . . . . ? Mostar . . . . . . . . Mehallet Hussein . . . . . . Santah Knfr Soliman . . . . . . . . Mit Birra . . . . . . . . Guetz . . . . . . . . Kafr-Dawar . . . . . . Choune . . . . . . . . Chirbine-el-Kanater . . . . Kafr Hegare . . . . . . . . 4 Echoune . . . . . . . . 3 Nefiche . . . . . . . . S Helouan , . . . . . . . . 3 Dinjouali .. .. .. .. 3 Bendarieh . . . . . . . . 3 Habate . . . . . . . . 3 El-Ayat .. .. .. .. 2 Assiout . • . . . > . . 2 Berket-el-Sab .. .. .. .. 1 Abou Kebir . . . . . . . . 1 Manfouma-el-Chibin . . . . . . 1 Chine . . . . . . . . 1 Kafr Sadat . . . . . . . . 1 Ziriba . . . . . . ? 1 Neguile . . . . . . . . 1 Atfe-el-Mahmoudieh . . . . . . 1 Total .. .. .. .. 11,645 70 Inclosure 2 in No. 53. Deaths from Cholera in Cairo (July 14, 8 A.M., to August 6, 8 a.m.). July July July July July July July July July July July July July July July July July July Aug. Aug. Aug. Aug. Aug. T , , Prtίnlafnn 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 1. 2. 3. 4? 5. Totai *' Po V^ &tlon - Gtoeh 5 4 30 28 15 33 68 95 55 56 81 24 51 46 45 38 28 23 6 14 .. Hospital .. .. ....') f .. 11 19 16 17 23 48 24 28 22 22 20 22 23 15 28 13 16 21 388 Boulak .. .. .. .. 51 108 161 216 273 259 121 121 63 73 54 36 39 48 47 25 29 21 19 1,840 52,065 Old Cairo .. .. .... 4 8 22 32 47 51 63 85 80 54 84 93 sfr 63 64 40 27 31 16 923 20,582 Esbekieh .. .< .. .. 2 11 17 30 31 37 38 28 23 20 20 18 23 14 12 10 8 10 4 356 58,799 Shubra ........ 3 10 31 10 18 26 18 15 22 17 14 8 16 18 9 7 13 4 261 11,070 Abdm .. .. .... 4 6 34 24 37 39 39 52 40 43 28 25 22 31 14 18 19 12 489 27,606 SaidaZenab .. .. .. V 3f 12 61 < 6 1 2 5 4 6 9 12 20 20 27 35 31 33 34 21 27 11 8 312 34,150 Halifa* ........ 2 1 5 5 6 5 6 7 6 9 14 7 6 4 4 4 91 36,707 Darb-el-Ahmar« .. .... 1 4 5 1 2 I 10 8 18 12 6 10 4 8 9 5 102 29,528 Mousky* .. .. .... 26255277 14 8977943 97 12,206 Bab-es-Sharieh* ...... 1 .. 5 8 9 16 18 14 13 19 13 15 20 11 14 16 10 11 9 222 41,944 Gamaheh* .. ...... 1 .... 115.. 51071068 2 5 1 62 29,748 Abbassieh*.. ...... J .. .. 3 4 3 7 4 6 12 23 11 2 5 6 7 6 7 106 13,703 Totals (without Ghiieb) .. .. 3 12 61 68 146 242 381 426 463 377 362 311 299 319 330 274 271 270 194 170 160 111 5,249 368,108 • These quarters are farthest from the Nile, f The totals for July 15, 16, and 17 are not classified, and are reckoned in the total of Boulak. 71 Sir E, Malet to Earl Granville. — (Received August 14.) My Lord, Cairo, August 6, 1883. WHEN reports arrived from Mansourah that there was distress and danger of famine Bowing to administrative mismanagement, a meeting was called together at Alexandria c leading European residents, and a Committee was formed to devise measures of I have the honour to inclose herewith copy of a Report issued by this Committee wilh regard to Mansourah, and of an article from the " Egyptian Gazette " based upon it. Your Lordship will perceive that the Committee lay great blame on M. Timmerman, fdnmnistrator of the Railway, and on General Baker and the Egyptian constabulary, charges formulated have found their echo in the English press, and constitute one of >rincipal grounds for impugning the entire Egyptian Administration with the exception ie Khedive, as is the case in the telegrams from the " Times '* correspondent at andria, published on successive days, and especially in the edition of the 25th ultimo, iich the correspondent calls upon me to correct a statement which he alleges to have made in the House of Commons on my authority, that there was a sufficiency of at Mansourah, and that when passenger traffic was interrupted a special service was organized by the Railway Administration. He proceeds to say that ample evidence has since been laid before me that no train Bd at Mansourah until the 14th, that the cordon officer, without whose permission could not be delivered, did not arrive until the 15th, and that prior to that date a famine existed in the town. The best source of information open to me was the reports of Mr. Murdoch, Acting ti Consular Agent at Mansourah, which I have had the honour to transmit to your lip. 1 also communicated each one, as soon as I received it, to the Minister of the >r. On the 4th July Mr. Murdoch wrote :* " There is, however, a danger of running )f provisions, caused by the refusal of the Railway Administration to receive goods xandria for Mansourah." On the 6th he says :f •* No provisions have yet arrived ilexandria, and every one complains of the want of food." On the 10th he writes :% shops in the town are almost out of provisions, and as the Railway Administration fuse to receive goods at Alexandria for Mansourah, we have the prospect of running short of provisions.*' In his Report of the following day, the 11th, appears the following passage :§ "Re- garding food, I beg to inform you that a supply of mutton has been pretty Well maintained, but poultry has been very scarce and dear, and, on account of the closing of the railway, no supply of provisions has reached the town for the last twelve days; consequently, the present stock has risen greatly in price, and to many poor Europeans, who are at present out of work, the prices have been prohibitory, and that is the principal reason there has been so much said about the want of food." At the close of the Report he states that the difficulty of the closing of the railway had been remedied. On the 12th he writes :|| "Now that the railway is open our principal wants will be supplied in a day or two ; and, in fact, it is the closing of the railway which has caused all this talk about shortness of provisions ; the price of mutton is now at its normal rate, and fowls and Bons are also reduced in price." Finally, on the 14th, he reports :^f " Regarding the supply, we have just received a consignment of provisions at 6 P.M. this evening, ng been at Talka over thirty hours. This arrival relieves our present wants, and if Bunication with Alexandria is kept up, we are not likely to run short again." ly impression on the whole is, that there was danger of a famine, but that arrange- ments were made in time, and that no famine ever, in fact, existed. With regard to no train reaching Mansourah till the 14th, Mr. Murdoch reported on the 10th, as will be seen above, that the difficulty of the closing of the railway had been remedied. The statement that the cordon officer, without whose permission goods could not be I ?red, did not arrive till the 15th ultimo, is, I think, founded on a misconception. An r had always been stationed at the point to which the trains run, but when the n became infected an outer cordon, ac a greater distance from Mansourah, was lished, and it was to the new point on the railway in this cordon that the officer in question came on the loth ultimo. • See Inclosure 1 in No. 20. § See Inclosure 2 in No. 58. f See Inclosure 3 in No. 20. H See Inclosure 6in No. 20. % See Inclosure I in No. 58. % See Inclosure 7 in Nu. 29. 72 _. Till • lit , i l 1 • 1 aI It is also proper that I should point out that the statement to which the correspondent alludes, as being made on my authority, was merely a telegram repeating the substance of a communication made to me by the President of the Board of Health, of which I have the honour to inclose a copy herewith. I am merely responsible for its transmission. The Mansourah Relief Committee telegraphed to me with regard to the refusal of the Railway Administration to give bills of lading for goods addressed to Mansourah, and I immediately requested M. Timmerman to endeavour to make some arrangement by which the difficulty thus created could be obviated. Because, however, I suggested to the Committee two ways in which the difficulty might be overcome, the Report says : " Sir Edward Malet seems to consider that the position taken up by M. Timmerman (the Administrator of the railway) is justified ;" and further on it says: "We find that shippers of goods first had their goods sent to the interior and relumed unopened; second, that their goods were refused at the railway stations ; and, third, that they would only be taken without the giving of any acknowledgment ; and we find that both S Timmerman and Sir Edward Malet approved of this last course." It appears by a vious paragraph that the Committee had anticipated the suggestion I had ventured to ke, and had sent goods on obtaining receipts marked " sans responsabilite." Ido not lerstand, therefore, why my making the suggestion should indicate that I, any more n the Committee itself, approved of the regulations, the inconveniences of which I Light it might obviate. The article from the "Egyptian Gazette" states that very grave charges against all authorities concerned are openly and publicly made, and I therefore inclose an article from the " Phare d'Alexandrie " denying that this is the case, and commenting on the allegations of the " Gazette " and the Report of the Commission. I have, &c. (Signed) EDWARD B. MALET. Inclosure 1 in No. 54. Dr. Salem to Sir E. Malet. M. le Ministre, Le Caire, le 1 1 Juillet, 1883. M. LE Dr. GRANT BEY ma communique* votre lettre en date dv 10 courant ainsi qu'une dep£che gui vous a 6te adresse'e de Mansourah. Je m'empresse de porter a votre connaissance cc gui suit : le Moudir nest pas de*missionnaire ; quant a I'approvisionnement de la ville, le Moudir, interpelle' par son Excellence le Ministre de Plnterieur, repondit qu'il e*tait suffisant et qu'il avait mime fait punir dcs marchands gui, profitant dcs circonstances actuelles, vendaient leurs produits h, dcs prix plus ele've's que d'usage. Les ordres ont etc* donnes par son Excellence Baker Pacha, au commandant dcs cordons, et par le Ministere de Plnterieur aux autorites locales, non seulement de ne pas s'opposer a l'introduction dans les villes atteintes par le cholera, de vivres, medecins, et medicaments, mais aussi d'en favoriser l'acces. Je crois devoir ajouter, que dcs l'interruption dcs communications par chemins de fer pour le public avec les villes atteintes, une service spe'eiale a e'te organisee par l'Administration dcs Chemins pour les besoms dv Gouvernement et le transport dcs me*decins, medicaments, et vivres. Veuillez, &c. (Signd) Dr. SALEM. (Translation.) Sir, Cairo, July 11, 1883. DR. GRANT BEY has communicated to me your letter of the 10th instant, as well as a telegram which you addressed to him from Mansourah. I hasten to bring the following to your knowledge : the Mudir had not been dismissed ; as to supplying the town with provisions, the Mudir, when questioned b; his Excellency the Minister of the Interior, answered that there was sufficient, anc that he had even punished vendors who, profiting by the present state of things, were selling their goods above the usual price. Orders have been given by his Excellency Baker Pasha to the Commander of the cordons, and by the Ministry of the Interior to the local authorities, not only not to put any obstacle in the way of food, doctors, and medicines entering the towns attacked oy me cnoiera, out-, on t oni ary, to promote it. 73 II think I should add that since the railways to the towns attacked have heen d, both public and special service has been organized by the Railway Administrato meet the wants of the Government and for the carriage of doctors, medicines, Pood. I am, &c. (Signed) Dr. SALEM. Inclosure 2 in No. 54. Report of the Mansourah Committee of European Residents. ¦WE, the Undersigned, having been named as a Committee to undertake the work of ;ing relief to the town of Mansourah, desire to make the following report of the state lings that we have encountered :—: — The first calls from Mansourah for relief came from Mr. Alfred Dale and from Messrs. Allich, Joubert, Dimier, and Fabbri. These gentlemen averred the critical condition of the town owing to imminent starvation added to disease. The statements of these gentlemen were afterwards confirmed by the following declarations made by the chief European inhabitants of Mansouvah. I »*ww . | 1 . A declaration signed by twenty-six European gentlemen, including M. de Binckhorst, Judge of the Tribunal of First Instance, showed the following state of things : That three or four days after the appearance of cholera a cordon was placed rounc the town of Mansonrah, and the railway communications were stopped on both the Talk and Zagazig lines. Not only was the ingress and egress of people disallowed, but also th ingress oi' provisions and medicine of all sorts which had been dispatched to Mansourah even before as well as after the institution of the cordon was prohibited. Chemists wh sought to bring medicines necessary for the occasion found difficulties, first, from th Railway Administration, who refused to accept goods for Talka without special authority and again from the cordon authorities, who refused to allow things to pass in spite of th urgent entreaties of the Moudir of Dakalieh. During the first days of the epidemic th town was in need of medical aid, and Mohammed EfFendi Fahri was the only Government doctor sent to afford help. In consequence of the stoppage in supplies the town suffered and was suffering up to the 1 1 th July, the date of the declaration, from actual scarcity of food, and from want of medicines, and especially of disinfectants. The scarcity of food is proved by the following Table, showing the rise in prices :—: — Per oke. P. c. P. c. Bread .. .. .. .. .. .. .. From 600 to 900 Mutton .. .. .. .. .. .. .. 13 16 20 24 Fowls .. .. .. .. .. .. .. 10 00 25 00 Potatoes . .. .. .. .. .. .. 3£ 8 00 Maccarcni .. .. .. .. .. .. 9£ 12 00 Butter . . . . . . . . . . . . . . 9| None. A proof of the scarcity of flour is that the chief European bakery, containing four ovens, had been obliged to close three ovens and stop the supplying of bread at the houses, being unable to supply his clients in consequence of the small stock of flour he had and of his inability to import further. The signatories testify to the zeal and activity of his Excellency the Moudir, and of Dr. Sierky Bey, but these functionaries are confronted by the apathy of the administrative personnel, and by the stubborn opposition of the Cadi and native Notables against the principal hygienic measures. The over-full cemeteries exhaling pestilent smells are spoken of as a constant source of danger. Corpses were being carried through the town without being in any way disinfected, and built tombs are opened again and again until filled with corpses, and this without disinfecting precautions. Mussulman funerals were being accompanied by crowds of persons in the usual fashion, all carrying more or less infection, gathered either in the houses of the dead or in the mosques where the corpses are placed, or at the tombs. The declaration finishes with a protest against this state of things. E. Another declaration signed by two chemists of" the town testifying to their urgent f suitable medicines and the difficulties they had in obtaining these owing to the iption on the railway and to the refusal of the Government authorities to allow to pass into the town. 3. Another declaration from two provision merchants of the town testifying that their shops were emptied of necessary provisions, and that they were unable to replenish thek 74 I * I.L * L «.* n t 1 n tUi-Tt j.iiiii rsr\A * /-v +ItQ IVsTllcni CI f fll*» Cfi VO I'" T>"» P t"l f StOl'6S OWMg 10 LUC interruption Oil llie iaiiway unu lO wiy iciusai vi me; uuvni.intin 14. Another declaration from the Director of the chief bakery testifying that he was ed to close his ovens owing to his inability to procure Hour. To his many demands nly reply he obtained was : " The railway will not accept flour for Mansourah." He " From the outbreak of the epidemic I have not been able to obtain one bag of from Cairo for the above reason." All these declarations are dated the 1 1 th July, and in no two declarations are signatures repeated. To these may be added another declaration signed by three gentlemen in Mehalla-el-Kebeer in date the 13th July, that, on the 9th July, they sought to send a live sheep to Mr. Dale at Mansourah, but the railway official refused to receive the same, stating that his orders were (hat. nothing could be sent by rail to Talka. On this occasion, by the kind offices of Mr. Gibson, Chief of the Cadastre, who arrived in Mehalla on the 11th July, permission was obtained to forward the said sheep to Talka, and it was so forwarded on that day, but on the 12th July orders were again received by the Mehalla Station-master that nothing whatever could be sent by rail to Talka. !Also, Mr. Thomas Knowies, of Mehalla, under date of the 14th July, gives this ier statement of Mr. Othon Papathymios, that on the 1 1th July Ahmed Bey Hamdi, -de-camp of His Highness the Khedive, said, in the presence of many gentlemen at the alia Railway Station, that he had telegraphed to every station in the name of His mess ordering them to receive provisions and medicines for the afflicted villages that railway communication. On the 12th, the day after this, the Mehalla Station-master received orders that he was to send nothing by rail to Talka. Again, the Committee have received the further evidence of persons in Alexandria which supports the truth of these declarations. M. Galetti, chemist, Alexandria, says tha on the 29th June the railway refused to accept goods which he wished to send Mr. Marco Tilche, chemist at Mansourah. It was only by the continued efforts of Dr. De Castro towards the Governor of Alexandria that the goods were at last sent, and M. Galett knows that they were afterwards left lying several days on the Talka Station before th consignee could obtain delivery. M. Galetti encountered the same difficulties when wishing to send cases of medicines for Dr. Haddad on the 14th July, who was sent to Mansourah by the Alexandria Committee, and goods which he had sent to Shibin-el-Kon were returned from that place ; and it was only after several days that he was able to again send them when the inhabitants had already suffered severely from the want of them Again on the 20th July, on the appearance of cholera at Ismailia, M. Galetti was requestec to send medicines to that town, but it was only on the 23rd July that he obtainec permission to send them to IsTefiche. It was on the first calls of Mr. Dale and the other gentlemen above mentioned tha we at once turned our attention to pressing on the Government authorities the necessity of allowing supplies to enter Mansourah, and we tender the following Report on the response we obtained from these officials. Our first and immediate step on our election on the 10th July was to wait upon His Highness the Khedive, and we take this opportunity of at once recording the prompt and active support we received from His Highness. His Highness immediately confirmed orders to the railway, the sanitary, and the cordon authorities that arrangements should be made for allowing the necessary supplies to enter Mansourah, and it was through this active behaviour on his part that relief was a last brought into Mansourah. With regard to the behaviour of the various officials, we make the following Report from the correspondence we have had the honour to hold witl them, and, against the various statements we have received from them, we must compare the actual experiences of the people in Mansourah as put forth in their declarations Immediately after our interview with His Highness we communicated to Sir Edwarc Malet, Her Britannic Majesty's Diplomatic Agent, and to M. Tinimerman, Administrator of the railway, the information received from His Highness, that he had ordered arrangements to be made for the entry of supplies into Mansourah, and we requested their influence in the matter. Sir Edward Malet replied on the 11th July, that Salem Pasha assured him that the Moudir of Dakalieh had telegraphed that there was no deficiency o: food, and that General Baker assured him "that the arrangements for the passage o: supplies sent work perfectly." M. Timmerman replied on the same date : " Provisions et medicaments sont recus depuis cinq jours par Talka." Kkgainst this statement of Salem Pasha we have the information from Mansourah that oudir telegraphed on 9th July an urgent appeal for assistance, and that he disclaimed possibilities if help was not- given, 75 chemists for destination of Mansourah. But o« the 13th further goods £cut to the Alexandria Station had to be taken back again, because the railway officials had received orders to give no bill of lading or receipt of any kind for goods to infected destinations, and to accept no responsibility in the same. Owners of goods naturally refused to hand over Kdvice of this interruption was at once, on the 13th July,. telegraphed to Sir Edward and M. Timmerman. ¦VI. Timmerman and Sir Edward Malet both replied, and we think it necessary to give replies in extenso. IM. Timmerman telegraphed on the 13th July : "II doit y avoir erreur par suite de >n. Marchandises ne peuvent pas etre livre'es dans la forme ordinaire ; elles seront irgees sur territoire neutre, ou les destinataires viendront les chercher sams controle. ne depend pas de moi mais de la situation." Sir Edward Malet telegraphed on the 14th July: "Your telegram of yesterday evening. The ordinary railway traffic to infected places is closed, but a special service has been organized. Neither goods nor passengers are transported as usual. The letter of Colonel Sartorius in yesterday's ' Egyptian Gazette ' explains the course to be taken. I can understand no merchant who individually is engaged in a business transaction will forward his goods without the usual guarantee of responsibility on the part of the Railway Administration. But there are two ways of obviating this difficulty : the Committee can either buy goods and forward them itself, or they can be responsible to the sender. M. Timmerman assures me that goods for Mansourah and other infected places forwarded under the regulations laid down by the Railway Administration will and do reach their destination. " Malet." ¦VI. Timmerman's reply shows an indifference to the state of the inhabitants of ourah so long as his railway is free of responsibility. I Sir Edward Malet seems to consider that the position taken up by M. Timmerman itifiable. He acknowledges the impossibility of any individual merchant sending his ies under such conditions, but he is prepared to approve that the Committee shall t responsibility to any extent on a simple verbal statement that goods shall reach r , rather than that the railway shall accept responsibility, although M. Timmerman uch confidence in the safe delivery of everything. We anticipated the suggestion of Sir Edward Malet by accepting a responsibility, and on the 14th July obtained railway receipts endorsed " Sans responsabiliteV' and gave our guarantee to the consignor. At the same time, we informed His Highness tbe Khedive of that which we were doing. Referring again to Sir Edward Malet's telegram above quoted, we read the long letter of instructions published by Colonel Sartorius in the "Egyptian Gazette" of the 13th July as to the course to be taken for the passage of goods through the cordon. We also read in a telegram sent by the "Times " correspondent in date of the 13th July the following: "Colonel Sartorius, who has just returned from inspecting the cordons, writes me thus — 'Baker Pasha has been trying since last Saturday week to induce the Government to send large supplies of provisions into Mansourah, but they will not.' " B)n the 1 7th July Colonel Sartorius telegraphed his astonishment that the Committee I not follow the course pointed out in his letter. We can best reply by referring to ove-mentioned private letter and to the obstacles found at the railway. B3n the 14th July Major Halroyd arrived at Talka to superintend the passage of through the cordons, and he was able on that evening at 7 o'clock to obtain the ry of the goods sent from Alexandria on the 12th July as above-mentioned. These goods seem to have been referred to in a note of M. Timmerman's, datec 14th July. He speaks of various packages of medicines and provisions, and a sheep being on the neutral island unclaimed, while Mr. Dale advises that the railway tickets for thes goods were received on the 12th, but through delay on the part of the sanitary clerk th goods could not be obtained until the evening of the 14th, which seems to have been th time of the arrival of Major Halroyd. EThis then is tbe position as regards the provisioning of Mansourah. On the one hanc nd M. Timmerman stating on the I lth July that goods were being taken by railwa 'alka for the last five days. We find General Baker assuring Sir Edward Male the passage through the cordon was working perfectly, and we find Salem Pash ming Sir Edward Malet that the Moudrr had telegraphed that there was «o deiicienc 76 lOn the other hand, we find that the shippers of goods (1) had their goods sent ta nterior and returned unopened ; (2) that acceptance of their goods was refused at the ay stations ; and (3) that they would only be taken without the giving of any owledgrnent, and we find that both M. Tim merman and Sir Edward Malet approved is last course. IWe find that the inhabitants of Mansourah, in spite of General Baker's assurance, J not receive goods until the evening of the 14th July, on the arrival of Major oyd, and that General Baker's Secretary, Colonel Sartorius, acknowledged the lity of General Baker himself to arrange for the free passage of supplies through the We find that, in contradiction to Salem Pasha's assurance, the inhabitants of Mansourah have made declarations testifying to the want of food in the town, and we find that the Moudir did actually make many appeals to Cairo for help, which help he could not obtain. Finally, we desire (o make a statement on the burial regulations. We learn on the 1 3th instant that, by the exertions of the Moudir, a piece of ground had been selected Rile the town of Mansourah to be used as a cemetery. This cemetery was brought ise on the 16th July. On the 19th July the Minister of the Interior revoked the for the burial of Mussulmans in this new cemetery, and allowed a continuation of Id cemetery situated in the town, and whicli is described as giving out smells which d over the town. (Signed) GEO. GOUSSIO. S. H. CARVER. W. J. WILSON. J. CUZZER. A. REMANDA. J. HEWAT. Alexandria, August 2, 1883. Inclosure 3 in No. 545. Extract from the "Egyptian Gazette" of August 3, 1883. A VERY serious charge has been brought against the Egyptian Government. It has not yet been legally proved, but it has been supported by evidence so overwhelming that, until at least some attempt is made to rebut it, the accused must incur the full odium of moral guilt. The charge made is one which, if proved, would possibly amount to manslaughter. Manslaughter has been defined to be the " unlawful killing of another without malice express or implied." It is of two kinds, voluntary and involuntary, and, among the latter, is classed "the neglect of a personal duty when death ensues as the consequence of such neglect." Now, in quoting these definitions, we by no means infer either that this amount o: guilt has been incurred, or that the rules of English law are applicable in such a case ; we only wish to show the gravity of the charge which is alleged, and we have to ask those interested whether they will choose to answer it by silence, by bare negation of facts, which negation no one believes, or by courting open inquiry. If the Egyptian Government were alone concerned, it might not perhaps be worth while to ask the question. The same absolute indifference which they have shown to cattle plague, to cholera, to threatening Niles, and to cotton worm they may be expected to show to any charge, however serious. When a Government gets to the point of publishing the protest of the native doctor against assistance being sent to the infected districts, we can only apply to them the doggrel epitaph of Prince Frederic :—: — He lived and was dead, There's no more to be said. But it is not alone the Government which is concerned. In moments when men are suffering under a great wrong they do not enter into abstract reasonings as to who is responsible ; they note the force they see fighting against them, and their first charge is against them. Now, in the Mansourah question the gendarmerie and the Railway Administration were the first apparent culprits ; the former ie under English, the latter, 77 for the time, under French direction, and it is against Baker Pasha and M. Jiramerman that the charge in the first instance lies. Now, in addition to absolute silence to or open challenge of the charge, there is a middle course which these gentlemen have certainly a legal right to adopt. They may say: "We are the accused, we await your formal attack in legal form;" such a course would undoubtedly place them at a great advantage, for in the present hybrid nature of law in Egypt and the utter desolation into which the victims have been thrown, the accused might feel pretty certain that they would be about as unassailable as a hedgehog by a mouse. We can hardly think, however, that English and French officials of high character will consent to shield themselves under such technicalities, and we confidently expect that they are only waiting for a cessation of the present abnormal state of things to demand the fullest inquiry. I The plain charge against them resolves itself into this : that, either by the execution ders of exceptional brutality, or by the exceptionally brutal execution of orders, or heir failure, through incapacity, to obey orders, they prevented the supplying of sourah for twelve days with provisions, medicines, disinfectants, or doctors ; that, in ;quence of one of these causes, they contributed to the death of a certain number of litants. I This is the charge, not perhaps yet legally brought to their notice, but openly and ely made ; they may possibly be in a position to disprove the whole, they may he to disprove a part, or to throw the onus upon some other shoulders, hut we cannot ye that they will do anything but challenge the fullest inquiry. ISo far as the other party to the question is concerned, we must confess that the f Committee have acted with all the openness and candour which we should have ited from them. There is no attempt to employ legal quibbles, to conceal their hand, fence the matter ; the proofs on which they rely are open to the world, they could y but he only too content if they could be disproved, for the charge is a painful one to ought in this country by one European against another. But, up to the present, no disproof has been offered, hardly even alleged ; our reader must have read, with as much pain and regret as we felt, the letter which Colone Sartorius thought fit to address us. We could hardly refuse to publish it, bu telegraphed, as it doubtless was, in a moment of haste, we think it would be ungenerous to take advantage of it. The very natural annoyance with which he saw in print utterance which he had probably intended as private led him further than he calculated, for Genera Baker's Military Secretary is the last man that would say in private that his chief ha< been for twelve days pursuing a certain course, and then, in a public utterance, say that he had not done so. EVe think the Relief Committee may wait, until the present abnormal state of things , with perfect confidence that General Baker and M. Timmerman will then make effort to clear themselves, by demanding a full inquiry from the serious charges now I against them. Inclosure 4 in No 54. Extract from the " Phare d' Alexandria " of August 4, 1883. Accusation d'Homicide. — Dans son nuinero d'hicr, " l'Egyptian Gazette " public un article long et virulent dans lequel elle cherche a faire de MM. Timmermann et Baker Pacha, les boucs ernissaires gui devront supporter les terribles responsabililes dcs malheurs de tous en Egypte. ¦'assant par-dessus la tete de ces honorables fonctionnaires, notre impitoyable confrere aut et fort, et accuse directement le Gouvernement d'homicide, ni plus ni moms. ID'est, dit-il, Je Gouvernement gui, par sa coupable indifference, sa perpetuelle apathie tribue" fortement k laisser croitre les ravages "dv typhus-bovin, dv cholera, dcs menacantes dv Nil, dv ver dv coton." »fais le Gouvernement nest pas le seul coupable dans cette ceuvre meurtriere qu'il B — au dire de notre confrere — s'etre imposee. II a pour complices MM. Timmeret Baker Pacha. ?•L'Egyptian Gazette" affirme que l'accusation portee contre eux peut se re'sumer ". . . . Soit par l'execution d'ordres dune brutalite* exceptionnelle, ou par Texecution exceptionnellement brutale d'ordres (! !), ou pour n'avoir pas, par suite d'incapacite ob^i a 78 B\ ordres, ils out empe'che' pendant douze jours I'approvisionnenient cb Mansourah en caments, provisions, disinfectants, ou docteurs ; que par suite dune de ces causes, ils :aus£ la mort dun certain nombre d'habitants." BEt cc journal ajoute :—": — " C'est la l'accusation dont ils ne sont peut-etre pas encore ?ment avises, mais gui est ouvertement et publiquement faite contre eux\" RNons protestons formellement contre cette derntere allegation. Nous ne connaissons iaker Pacha, mais en cc gui concerne M. Timmermann, nous savons tres certainement 'opinion publique ne se prononce pas contre lvi, nous savons que personne ne songe reprocher les maux desquels souffre le pays. M. Timmermann est, au contraire, l'un les plus sympathiques que nous connaissons, et l'un de ceux fort raves, on ne doit parler que pour faire dcs diloges. Nous suivons depuis longtemps les travaux de son Administration, et nous avons vu la un travail constant et e*claire. Duquel dcs nouveaux fonctionnaires pourrait-on en dire autant ? En cc gui concerne l'accusation en elle-m6me, elle tombe a plat devant le ridicule. Nous en de'me'lons sans peine I'intention pour laquelle le journal accusateur sacrifie de gaiete de cceur son compatriote et son ami Baker Pacha; mais a gui fera-t-on croire que la responsabilile dcs faits peut &tre impute'e a dcs fonctionnaires dont le role en toute cette affaire a etc cssentiellement passif? M. Timmermann, Administrateur dcs Chernins de Fer, n'a fait qu'executer les instructions recues, avec sa competence et sa ponctualite' habituelles. Mais a-t-il decide que le train s'arre'terait a tel endroit plutot qua tel autre, et que le service journalier serait rdgle* de telle ou telle facon ? Non. Eh bien, c'est avec ceux gui ont de'crete ces mesures qu'il faut discuter si elles sont mauvaises ou bonnes. Et puisque notre confrere nous permette de le lvi dire, en cc gui concerne l'affaire de Mansourah on a mene grand tapage la ou il y en avait a faire bien peu. U y a eu dv desordre nous n'en disconvenons pas, mais comment pr&endre l'eviter en de semblables circonstances. Pour etre franc, il faut bien avouer qu'il y a seulement la une Commission gui, apres s'e"tre nominee de sa propre autorite, a tenu a se prouver a elle-meme qu'elle e"tait indispensable. II ne serait pas difficile d'en trouver parmi les habitants de Mansourah gui protestassent formellement cotitre les imputations que releve v l'Egyptian Gazette " contre M. Timmermann. Mais il nest pas besom mSme de ces temoignages ; la reputation de haute competence et d'honorabilite dv sympathique Administrateur dcs Chemins de Fer est e'tablie depuis trop longtemps pour qu'elle puisse souffrir d'accusations aussi peu fonde'es. (Translation.) Chaege op Homicide. — In yesterday's number, the " Egyptian Gazette " publishes a long and virulent article in which it seeks to make M. Timmermann and Baker Pasha the scapegoats to be burdened with the terrible responsibility of the misfortunes of all in Egypt. Going over the heads of those worthy officials, our pitiless contemporary aims high and low, and directly accuses the Government of homicide, neither more nor less. The Government, so it says, by their culpable indifference and their continued apathy, has done very much towards letting the ravages of " bovine typhus, of cholera, of the dangerous rise of the Nile, and of the cotton-worm " increase as they will. But the Government is not alone in the murderous task which it seems, according to our contemporary, that they have set themselves. Their accomplices are M. Timmermann and Baker Pasha. The " Egyptian Gazette" assures us that the accusation made against them maybe summed up as follows :—: — a Either by the execution of orders of exceptional brutality, or by the exceptionally brutal execution of orders (I !), or by having failed through incapacity to obey orders, they prevented Mansourah being supplied with medicines, food, disinfectants, or doctors during twelve days ; that, in consequence of one of these causes, they caused the death of a certain number of inhabitants." And the paper adds :—": — " Such is the charge of which they have not perhaps as yet had legal notice, but which is openly and publicly made against them." We protest formally against this latter statement. We are not. acquainted with Baker Pasha, but as regards M. Timmermann we know for certain hat public opinion 79 is not against him ; we know that no one dreams of blaming him for the ills the country suffers. On the contrary, M. Timmermann is one of the kindest officials we know, and one of the very few of whom one cannot speak hut in praise, ¦We have long watched the work of his Administration, and we have observed ¦nued and enlightened labour. Concerning which of the new officials could uch be said ? BU for the accusation itself, it can only be laughed at. We can easily see the 1 the accusing paper has for cheerfully sacrificing its compatriot and friend Baker ',; but who will believe that the responsibility for what has happened can nputed to officials whose duties throughout have been essentially passive? mmermann, Manager of the Railways, did but execute with his usual ability and uality the orders he received. ¦Did he settle where the trains were to stop, and how the daily service was to be ucted ? No. Well, it is with those who did that we must discuss whether these ures were bad or good. ¦And if our contemporary will permit us. to say so, with regard to Mansourah it )een a case of much ado about nothing, or very little. ¦There was disorganization, we do not deny it, but how could it be prevented in circumstances ? To be frank, it must be confessed that it is only there that s is a Committee which, after having created itself by its own authority, has shown f indispensable. Xt would not be difficult to find among the inhabitants of Mansourah persons who formally protest against the imputations made against M. Timmermann by the ptian Gazette." ¦But such testimony is not wanted ; the kind Administrator of the Railways has i reputation for great competence, and has been held in honour too long for him to r from such groundless charges. No. 55. Sir E. Malet to Earl Granville. — (Received August 14.) |n*d, Cairo, August 6, 1883. HAVE the honour to inclose copies of cholera Reports from the British lar Agents at Zagazig and Birket- es-Sab. I communicated these Reports President of the Board of Health, and I have the honour to inclose a copy of a from his Excellency, returning them to me, and stating that their contents shall jnded to. I have, &c. (Signed) EDWARD B. MALET. Inclosure 1 in No. 55. Dr. Salem to Sir E. Malet. RMinistre, Caire, le 5 Aodt, 1888. MI l'Jionneur de vous remettre ci- joint copie de trois lettres adresse'es par votre BConsulaire de Zagazig a Mr. Borg, et que celui-ci a bien voulu me com-3 Conseil de Sante a pris bonne note de leur contenu et fera son possible pour er aux inconve'nients signale's, en cc gui lvi appartient. Veuillez, &c. (Signs') Dr. SALEM. (Translation.) ¦Ministre, Cairo, August 5, XBB3. HAVE the honour to inclose herewith copy of three letters addressed by your ¦lar Agent at Zagazig to Mr. Borg, and which the latter has been good enough to unicate to me. ¦Che Board of Health has taken note of their contents, and will do all that lies in wer to remedy the inconveniences indicated, as far as belongs to it. Accept, &c. (Signed) Db. SALEM, 80 Inclosure 2 in No. 55. Mr. Felice to Vice-Consul Borg. Dear Mr. Borg, Zagazig, July 30, 1883. KMANY of the inhabitants of Kafr Zagazig are dying to-day without any ;ance ; the town is short of doctors and men. If no measures are to be taken it ite useless for me to keep writing by every post. I The Report of the 28th, showing nine deaths at Zagazig, is quite incorrect ; it ell known that more than forty died of cholera on the 28th, and yesterday teen. The burying is as bad as it can be ; no consideration is shown either for humanity or for sanitary requirements. I am, &c. (Signed) S. FELICE. Inclosure 3 in No. 55. Mr. Felice to Vice-Consul Borg. Dear Mr. Borg, Zagazig, July 30, 1883. THE private reports which I have from town are that sixteen persons died of cholera yesterday, and some oases occurred at Minet-el-Gamb. There are many sick here, and even the rich are dying without medical or other assistance ; I can obtain no information from the local authorities. I have called the attention of the Vice- Governor to the existing state of things, and requested him privately to give orders to the native inhabitants to start fires, with the object of disinfecting the town. The verbal reply to my janissary was " Hader " as usual, but no fires have been lighted. I have started the example myself, but have found no imitators. The burials are very badly executed ; they scarcely bury 2 feet below the ground, and the consequence of such neglect will be some other epidemic in the future ; the cemetery is quite close to the town. Until the disease appeared here the natives would not believe that Egypt was visited by an epidemic ; their impression was that it was an excuse on the part of the British Government to justify the withdrawal of the troops. I am, &c. (Signed) S. EELICE, Inclosure 4 in No. 55. Mr. Carr to Vice- Consul Borg. Sir, Birket-es-Sab, July 30, 1883. I HAVE to inform you that during the past ten days the attacks of cholera have steadily increased in this neighbourhood, and I presume that there is at th present time no part of the country with such a relatively high rate of mortality as w have here ; it is most difficult to ascertain the number of deaths, but from persona observation I should say it is at least twenty-five per day in the adjoining villages o Birket-es-Sab and Dia-el-Com, and in other villages in the neighbourhood as bad or worse It is worthy of remark that in the official He turns, as published in the daily papers no mention whatever is made of the villages in question. I need hardly inform you that not the slightest medical aid is in any case rendered to the poor sufferers excep such as is voluntarily supplied by European residents ; in fact, as you are doubtless well aware, the natives dread the sight of the Government doctors ; but irrespective o: the use of medicine or other remedies, there is one point which I think the Egyptian Government should endeavour to enforce in the villages, viz., the disposal of the clothes and coverings which have been worn by, or been in contact with, deceased cholera patients. This is a matter which does not in any way interfere with religious prejudice or custom, and it is a shame that the poor ignorant people should be allowed to spread the disease by wearing and using (without disinfection) the clothes of theii deceased relatives. In Tantah the greatest credit is due to the Mudir for the manner in which he has carried out the sanitary regulations, and doubtless the comparative naucitv of fatal 81 cases m mat large town is ciue 111 a great measure to tiie energy witn \^nicn 11© uns discharged his duties, but in the outlying villages the people are left pretty much to their own devices, and a great increase; in mortality is the consequence. ¦Up to the present only two Europeans have died here from cholera, both of whom Greeks. I am, &c. (Signed) 0. SPENCER CARE,. No. 56. Sir E. Malet to Earl Granville. — (Received August 14.) My Lord, Cairo, August 6, 1883. I HAVE the honour to inclose copy of a letter from Khairy Pasha, the Minister of the Interior, forwarding to me letters of introduction for the English doctors who have been sent to towns in the provinces. I have, &c. (Signed) EDWARD B. MALET, Inclosure in No. 56. Khairy Pasha to Sir E. Malet. M. le Ministre, Le Caire, le 4 Aout, 1 883. EN reponse a la lettre en date de cc jour que votre Excellence ma fait l'honneur de m'adresser, je m'empresse de lvi remettre sous cc pli quatre lettres en langue Arabe pour les Moudirs de Damanhour, Zagazig, Mehallet-el-Kebir, et le Gouverneur de Rosette. Ces lettres, dont seront munis les me'decins Anglais diriges sur les villes ci-dessus, contiennent les instructions indique'es dans votre de"peche. EEn outre j 'invite directement ces fonctionnaires a prendre leurs dispositions pour i* convenablement ces messieurs, en leur fournissant les meubles necessaires et de prater toute I'assistance que comporte raccomplissement de leur mission. V'appuie principalement sur cc fait que le me"decin de'le'gue' dv Conseil deja sur les est sounds a la direction dv porteur de la lettre de presentation. Veuillez, &c. (Signe) KHAIRY. (Translation.) Sir, Cairo, August 4, 1883. BIN answer to the letter with which your Excellency honoured me to-day, I hasten close four letters in Arabic for the Mudirs of Damanhour, Zagazig, Mehallet-elr, and for the Governor of Rosetta. I These letters, which will be carried by the English doctors sent to those towns ictively, contain the instructions requested in your despatch. I have further instructed those officials explicitly to take measures for giving s gentlemen suitable lodging, for finding them the necessary furniture, and for g them all the assistance the fulfilment of their mission requires. Bcall special attention to the fact that the doctor already sent to a place by the is placed under the orders of the bearer of the letter of introduction. I am, &c. (Signed) KHAIRY. No. 57. Sir E. Malet to Earl Granville. — (Received August 14.) My Lord, Cairo, August 6, 1883. I HAVE the honour to inclose herewith a copy of instructions sent by Mr. Vice- Consul Borg to the British Consular authorities in his district as soon as it was established that cholera had broken out at Damietta. I have, &c. (Signed) EDWARD B. MALET. [1523J 82 Vice-Consul Borg to British Consular Authorities in his District. Sir, Cairo, June 28, 1883. IT appears from the Summary Report made by the Medical Commission that the disease which has appeared at Damietta presents the symptoms of cholera, and offers the characteristics of an epidemic. Tt is ardently to be hoped that the measures which, I am informed, have been taken, may localize the disease to that town alone, and lessen the chances of an invasion of the disease in your district, or render it as mild in type as possibly could be, but it is absolutely necessary that all causes favourable to the development or propagation of the germ should be promptly removed. T could not sufficiently dwell upon the importance of having the hygienic condition of the town very carefully and minutely looked after by the authorities, and of having any attempt to evade the sanitary regulations firmly and promptly repressed. You will, therefore, on the receipt of this despatch, call the serious attention of the Mudir to the grave responsibility that would weigh upon him should the district be visited by the epidemic through any negligence or apathy on his part, or through the carelessness of his subordinates. You will advise him to give strict orders that streets and houses should be cleansed and disinfected, that all nuisances, such as pools of stagnant waters, carcases of dead animals, &c, should be abated, that unripe or decayed fruit or vegetables, diseased or decayed meat or fish, should be destroyed, and that prompt assistance should be rendered to the sick and indigent ; and you will urge upon him to see that his orders be punctually obeyed, and that any evasion or abuse should be promptly and sternly repressed. And you will let me know in which manner the communication will be received and acted upon, and report, from time to time, whether and how these and such other prophylactic measures as might be dictated by the sanitary authorities will be carried into effect. It being desirable, should the disease unhappily visit your district, that for a general as well as for a scientific interest I should be kept regularly informed of the progress that it might make, I inclose a form of return, and have to instruct you to supply it to me at least twice a-week. You should reckon the daily periods from the midnight of one to the midnight of the following day, and you should be careful to make regular thermometric observations, and note in the columns of the Return whether you use a Fahrenheit, Reaumur, or centigrad thermometer. In the column for remarks you will state the quarter of the town tha would seem to be more severely afflicted, and whether due to purely local causes, whic class of the population would be most affected, whether any cases are followed by imme. diate death, what treatment or medicine may give better results, and generally auy othe remarks that you would consider of interest, and you will state as nearly as possible th age of the persons attacked by the disease. I am, &c. (Signed) RAPH. BORG. No. 58. Sir E. Malet to Earl Granville. — (Received August 14.) My Lord, M 7 M 7 -Lord, Cairo, August 6, 1883. I HAVE the honour to inclose herewith copies of Reports from Mr. Murdoch respecting the cholera epidemic at Mansourah. I have, &c. (Signed) EDWARD B. MALET. Inclosure 1 in No. 58. Mr. Murdoch to Vice-Consul Borg. Sir, Mansourah, July 10, 1883. I HAVE to acknowledge receipt of a telegram from Her Majesty's Agent an 4 Consul-General requesting me to telegraph present state of affairs, 83 in horrible state. Moudir resigned. Send tents." ¦[ should have added that these fifty deaths to-day took place in ten hours, whereas thers were during twenty-four hours. Last night I was informed that the graveyard was in a bad state, and in order t satisfy myself of the truth of the statement I made a personal examination of i to-day, and not only found that I had been correctly informed, but matters were eve much worse than I expected. There were at least fifteen dead bodies waiting thei turn, and being accompanied by relations, friends, &c, a great number of people hac collected round the place, and a more fertile system of propagating the disease coul not well be imagined. I also found that when a grave (or rather brick-built tomb was filled up it was sealed up in the most primitive way, affording no security agains the issue of bad air, effluvium, &c. I[ called immediately on the Moudir, and protested most energetically against the er continuance of such an abomination, and suggested that he should immediately re a feddan of land some distance from the town and make a fresh grave, every Lsing a plentiful supply of quicklime, &c. ¦He is to select a piece of land to-morrow and take possession of it, with or out the permission of the proprietor, and he explained that he had written to the ster of the Interior some days ago on the subject, and had not been favoured an answer. X would suggest that the Moudir be endowed with fuller powers, so that he can an emergency of this kind without consulting Cairo. I Regarding his resignation, he said that he experienced the greatest difficulty in rig his orders executed by his subordinates and the non-arrival of tents, order to ibute food to the poor, &c, that he was quite disheartened, and unless these les and orders were sent he threatened to resign. It appears there are over 2,000 Le in Mansourah now that do not belong to the town, and who are almost ing and cannot get away, and he required those tents to allow these persons to outside the town, and feed them at the expense of Government. ¦The shops in town are now almost out of provisions, and as the Railway anistration still refuse to receive goods at Alexandria for Mansourah we have tho pect of running short of provisions, and this tends to increase the panic and r now existing all through the town. Please urge upon the Administration the Lute necessity of at once allowing provisions to come from Alexandria. I understand the arrangements with the cordon are now working satisfactorily. I From cases of cholera that have come under my notice, I find that over one-half of leaths are of persons whose distrust or disbelief in medical aid is such that when get ill they will on no consideration call a doctor, or even if the doctor calls absolutely refuse to take the medicines prescribed, and Sidky Bey confirms my E Under these circumstances, I would suggest that more doctors be sent, so that jy may be able to visit the houses more than they are at present able to do, and end to any person whom they may find ill during their travels. Also, two or three nale doctors to enter the harems and insist on their being properly cleansed and infected, because at present that part of the houses are still unexamined, except at little the doctress is able to do. I am, &c. (Signed) FREDERICK T. MURDOCH. Inclosure 2 in No. 58. Mr. Murdoch to Vice»Consul Borg* Sir, Mansourah, July 11, 1883; I AM in receipt of telegram from Sir E. B. Malet, and beg to confirm my reply as follows : — 11 Ask Baker Pasha extend cordon beyond Palace for tents ; food exists famine prices ; grandson and servant Mudir dead, will arrange take feddan land for graveyard to-morrow ; ninety-three deaths, eighty-one cholera, twenty-four hours ; railway open, principal wants supplied to-morrow ; send order authorizing Mudir give 2,000 rations per day, urgent, many starving." The Mudir made an arrangement with me last night that he was to go with me 84 lilect a piece of land for a graveyard this morning, but when I called at his house md his servant had died and his grandson was very ill, and when I called again afternoon he informed me that his grandson was also dead, and he was so much ted that I did not press him to go and select the ground, and he promises to go r ith me to-morrow. I As this is now the most important defect in the sanitary arrangements here, I 3 told the Mudir that in the event of any opposition being offered by the proprietor tie land that may be selected, he must not hesitate but at once take possession, and price can be arranged afterwards by arbitration or otherwise. He suggested that he would prefer to have the requisite authority from the Minister of the Interior before doing so, but I assured him that he would incur no censure by acting promptly. Regarding the food, I beg to inform you that a supply of mutton has been pretty well maintained, but poultry has been , very scarce and dear, and on account of the closing of the railway no supply of provision has reached the town for the last twelve days ; consequently the present stock has risen greatly in price, and to many poor Europeans who are at present out of work the prices have been prohibitory, and that is the principal reason there has been so much said about the want of food. I beg to inclose a list of cases and deaths, but I find that the list of new cases is very inaccurate, as some that have come under my notice were dead before the doctors were advised, and were not entered as new attacks at all, but merely put in the list of deaths. I find that the subordinates of the Mudir are almost completely demoralized, and with the exception of the Wakeel of the Mudirieli, and one or two clerks, they do not execute his orders as promptly as could be desired. Sakeb Bey, the Wakeel, has shown himself to be a capable and hard-working official ; if his assistants were equally so matters would be much better than they are. Mr. Dale has received several telegrams from Mr. Bell, Alexandria, informing him of the formation of a Committee there, and asking him to form another here and communicate with the Alexandria one in order to make known the wants of the Europeans and natives here. A meeting was held here to-day, and a Committee formed, a telegram being sent to Alexandria to the effect that they required two European doctors and a new graveyard, which they considered the most pressing requirement now that the difficulty of the closing of the railway has been remedied. I am, &c. (Signed) FREDERICK T. MURDOCH. Inclosure 3 in No. 58. Return of Cases and Deaths from Cholera in Mansourah from the 6th to the 11th July, 1883. Number of new Cases. Number of Deaths. Temperature, Fahrenheit Date. Thermometer. Direction of Wind Europeans. Natives. Europeans. Natives. at 4 i-.m. • ' 1 9 a.m. 4 p.m. Males. Females. Males. Females. Males. Females. Males. Females. July 6 82 88 W. strong breeze ..3 .. 25 24 1 .. 20 22 I 7 83 89 „ 1 1 3 5 1 .. 34 22 8 83 90 W. light breeac .... .. 5 5 .. 1 16 17 9 83 91 „ .... 1 7 C 1 32 49 10 82 90 „ ..1 2 1 2 1 2 51 51 11 83 92 The greater number of deaths from centre and most populous part of the town. (Signed) FREDERICK T. MURDOCH, Acting Consular Agent, 85 No. 59. Sir E. Malet to Earl Granville. — (Received August 14.) My Lord, Cairo, August 6, 1883. tl OBSERVE from the Parliamentary Reports that questions were asked in th se which showed that a supposition existed that much unnecessary suffering wa sd by the removal of a part of the population of Boulak shortly after the cholera hac ?n out there. There is, indeed, no doubt that the removal of some thousands o ns at short notice from their homes did create much suffering, but the result showec it was a wise administrative measure, for the cholera rapidly decreased at Boulak a as it was carried out, and it did not appear with any severity among those who wer removed to Toura and to the Barrage. I have, &c. (Signed) EDWARD B. MALET. No. 60. Consul Cookson to Earl Granville. — (Received August 14.) My Lord, Alexandria, August 6, 1883. I HAVE the honour to forward herewith to your Lordship a despatch addressed Bby Mr. Mieville, inclosing a Memorandum on the comparative immunity from a hitherto enjoyed by the city of Alexandria. I have, &c. (Signed) CHAS. A. COOKSON. Inclosure 1 in No. 60. Consul Mieville to Consul Cookson. Sir, Alexandria, August 6, 1883. I HAVE the honour to forward a Memorandum on the comparative immunity from cholera enjoyed up to the present by the city of Alexandria. I have endeavoured in this form to briefly place on record certain considerations to which, when the present epidemic shall happily have terminated, and the whole history thereof come under review, I venture to think some interest may attach. I have, &c. (Signed) W. F. MIEVILLE, British Delegate. Inclosure 2 in No. 60. Memorandum by Consul Mieville on the Comparative Immunity from Cholera enjoyed up to the present by Alexandria* P WHETHER the city of Alexandria will happily be spared altogether from ;ra in an epidemic form we cannot presume to foretell, and even whether, should as declare itself, the city will escape lightly, is a question where prediction might t fault. Yet I venture to think that, whatever happens, some interest may attach to the following reasons, which occur to me, as explaining in some degree why since the first appearance of the cholera in Egypt, six weeks ago, Alexandria has enjoy ec almost entire immunity from the disease. There can be little doubt, I take it, thai this is due in the main to the following causes : a plentiful supply of good water and a sufficiency of pure air. The water is taken from the Mahmoudieh Canal, which in turn receives its supply from the Rosetta branch of the Nile at Atfeh. On an average, 21,000 tons are daily pumped into the Alexandria pipes, and considering the population of the town does not exceed 210,000, the supply therefore is abundant. As to the quality, I have only to mention that since the month of May last a patent composition, " aluminoferic," has been continuously mixed with the water to cause a deposit of part of the earthy 86 matter contained therein ; and this before the water has been allowed to enter the filter-bed, whence it passes through sand into the pipes. In addition, permanganate of soda has, during the last few anxious weeks, been daily used, with a view of destroying to some extent the organic matter, and the result has been capital The second point, viz., a sufficiency of pure air, may be considered as affording a curious and striking instance of how unexpected good may arise out of events which appear at the time of their occurrence calamitous in the extreme. Little more than a year ago a great portion of the European quarter of Alexandria was wantonly destroyed by incendiaries, the great square and some of the principal streets being after the fire simply heaps of charred ruins. The walls, it is true, were in many cases left standing, bearing gaunt witness to the past, but these have since either fallen, or have been removed, and the total area once occupied by the buildings thus destroyed is now open space, some 115,000 square yards in extent, and serves to day as lungs to the city, whereas, had the fire not occurred, it would be covered as aforetime with unhealthy, wretchedly-drained buildings, most of them many storied, and by their great height shutting out light and air from the houses behind them. It seems probable that the action of the fire itself must also have done vast good in purifying Alexandria, but, however this may be, the fact still remains that the burning of the European quarter gave the city new lungs, covering nearly 24* acres of ground, situated, moreover, so advantageously, that the fresh sea breezes from the north can now reach those squalid quarters where light and air are most wanted, yet hitherto have been least known. Prominently, however, as the above points may present themselves to the mind as having contributed to the escape of the city hitherto from a heavy visitation of the scourge now passing over Egypt, it would be unjust not to mention other causes, to which undoubtedly much is due. An organization, ad hoc, known as the Alexandrian Extraordinary Sanitar Commission, which owes its primary existence to the initiative of Mr. Consul Cookson has done good work, in cleansing not the streets only, but the hovels and huts of th poorer classes, and also by inducing those in a better station of life to carry out in their own houses such ordinary sanitary precautions as are so often overlooke( or neglected. The Commission has also been instrumental in causing the removal o vast accumulations of filthy refuse ; has exercised supervision over the food supply o the city, and has prevented an undue agglomeration of refugees from congregating in Alexandria. Thanks also to the exertions of Mr. Cornish, the resident engineer, and Manage of the Alexandria Water Company, the sewage of the town has, since the 9th Juty been pumped out into the bay into 6 ft. 6 in. depth of water. At two points, engine* and pumps, with pipes to the summit levels of some of the sewers, have been placet to pump up sea-water for flushing them, and at three other points water has been lai< on from the Water Company's mains. Boilers also have been placed for melting strong solution of sulphate of iron, which is mixed with the water at the points wher it is run into the sewers, and gangs of men are employed in putting temporary dam into the sewers to divert the course of the water in different directions, the dam being suddenly drawn when the sewer becomes full, thus causing a rapid flush. It must unfortunately be admitted that the sanitary condition of certain quarter of the town is, nevertheless, still bad enough to of itself breed pestilence ; yet almos all that could have been done since the epidemic declared itself at Damietta in Jun last has been accomplished, and though it would be rash to predict confidently as to the future, yet we may at least reasonably hope that the scourge, should it ultimatel; gain some hold here, will not commit such ravages as during the visitation of 1865. (Signed) W. P. MIEVILLE. Alexandria, August 4, 1883. No. 61. Consul Cookson to Earl Granville. — (Received August 14*) My Lord, Alexandria, August 6> 1883. I HAVE the honour to forward to your Lordship herewith a despatch addressed to me by Mr. Mie>ille relative to the official bulletins to the progress of cholera* I have, &c. (Signed) OHAS. A. COOKSON. 1 87 Consul Mie'ville to Consul Cookson. Sir, Alexandria, August 6, 1883. THE total number of deaths reported up to the 29th July inclusive was 10,237. It has now risen to 16,117, thus showing the last week's mortality throughout Egypt to have been 5,880, or an average of 840 daily. Since the 24th July there have been daily deaths from cholera in Alexandria, and from the best statistics I can gather there appear to have been in thirteen days (24th July, 8 a.m., to the 6th August, 8 a.m.) 49 attacks and 33 deaths, while the general health of the town continues excellent. I have, &c. (Signed) W. F. MIEVILLE, British Delegate. No. 62. Consul Cookson to Earl Granville, — (Received August 14.) My Lord, Alexandria, August 6, 1883. I HAVE the honour to forward herewith a copy of a despatch from Mr. Mie'ville, inclosing printed copies of a Report by the Doctors Chaffey Bey and Ferrari, on the origin and nature of the present epidemic, I have, &c. (Signed) CHAS. A. COOKSON, Inclosure 1 in No. 62. Consul Mie'ville to Consul Cookson, Sir, Alexandria, August 6, 1883. BHAVE the honour to forward herewith printed copies of the Report by the rs Chaffey Bey and Ferrari on the origin and nature of the prevalent epidemic. To this Report, which, from my experience of these two gentlemen, I believe is entitled to be received with confidence, two other papers are added : one giving an analysis of samples of the drinking water of Damietta, and the other being a letter from the health officer at Suez as to the sanitary condition of the British steamer " Timor," from which vessel, it will be remembered, landed in June last the stoker Mahommed Khalifa, through whose agency it has been alleged the cholera was imported into Damietta. I have, &c. (Signed) W. F. MI^VILLE, British Delegate. Inclosure 2 in No. 62. [The French text appears in ¦ Commercial No. 38 (1883)," pp. 9 to 21.] (Translation.) H The Outbreak of Cholera at Damietta in 1883. Its Origin and Spread,* 1 Report to the Maritime Sanitary and Quarantine Board of Egypt, by Ahmed Chaffey Bey and Salvalore Ferrari. Damietta, July 24, 1883. THE two Committees, of which the Undersigned were members, and which came to Damietta the 14th June, 1883, to ascertain the existence and nature of the disease which was raging in that town, having pronounced it epidemic cholera, the Maritime Sanitary and Quarantine Board instructed me at its meeting of the 27th June d to go to Damietta to inquire into the origin of the cholera epidemic. Br. Ferrari, Director of the Health Office at Damietta, was asked to join me in Dg the mission confided to me by the Board. Relying on the confidence thus placed in us, and thoroughly appreciating the importance of the matter, we made long and minute inquiries, the result of which will be found in the Report which we now have the honour to submit to the Council. 88 § I. — Topographical and Hydrographical Sketch of the Town of Damietta, from a Medical Point of View. The town of Damietta is on the east bank of the Nile, about 13 miles above where it runs into the Mediterranean. The soil on which the town, which is actually washed by the waters of the river, stands is Nile alluvium. The construction and lie of the town is in shape like a horse-shoe, in the curve of which the current is considerably delayed, and at the period of the low water of the Nile the sea runs back into it. The town consists of very ancient buildings, saturated with damp, very crowded, for the most part in ruins, without any yards, and those which look as if they had yards have only a sort of narrow hall, which is both damp and dark. This is the case with the dwellings of the moderately well-to-do, while the greater number of the houses are in reality nothing more than mere underground cellars, which could well be called cesspools. Besides these there is a third kind of dwelling very common throughout the country, namely, the huts or cabins made of straw, mud, and animal excrement. The streets are very narrow and crooked, the sun hardly ever shines into them. There is no boulevard, public place, or garden. The surface covered by the tow T n may be about 1 kilom. long by nearly 600 metres wide. According to the returns of the last census the population of Damietta is 35,000. The population is of the Egyptian race, almost unmixed ; the Syrian element is represented by hardly a thousand individuals ; there are but very few Europeans. There are a few merchants and rice growers, but the principal occupations are those of the sailor and fisherman. Mohammedanism is the dominant religion. The whole population, including even the rich natives, feed almost exclusively on fish and rice. A large proportion of the natives prefer a kind of rotten salt fish called ' ' fissikh ' ' (herrings) . The only drink is water. The rich fill their cisterns with the water of the high Nile, and thus lay in a supply for seven months ; but those who have no cisterns drink throughout the year water which they draw from the river, or from the haligh (canal) which runs through the eastern part of the town. There are empty barracks, a factory in ruins, and one single hospital with one doctor and one chemist; there is no school. There are many cemeteries ; they are used for the burial of bodies brought from the whole neighbourhood ; these cemeteries surround the town like a belt, and lie more especially on the north side ; they are thus on the side of the prevailing wind, and some are in the very midst of the houses. In the middle of the town there is a large dep6t of the rotten fish mentioned above, besides places (" daouar ") for storing raw hides for exportation, of which there is even now a certain amount. What strikes the visitor as he goes through the town is the number of ruined enclosures (kharabeh) which are found in lines in all parts of the town, and are filled with heaps of filth; there are as many as thirty-four in one single district. Besides these great deposits of filth there is to the right of the door of the Jews' " okelle " a large well full of fsecal matter, which is emptied by means of an elevator like those used in the country for watering the fields (sakiah) ; what is taken out runs along open gutters into the large drains from the public baths, which fall into the river. All along the streets and alleys there are little heaps of excrement, &c. Both the Medical Committees which came to Damietta on the 24th June to investigate the existence of the disease had already noticed this unheard-of want of sanitary precaution, and it was not till after their departure that the principal streets were first swept.* * In February last, Dr. Ferrari, Director of the Health Office at Damietta, sent the following, now translated from the Arabic, to the principal Doctor of the town :—: — " Having received instructions to report to the Maritime Sanitary and Quarantine Board of Egypt on the sanitary state of the town, I have been through the streets and principal parts of the town. I have ascertained that the whole place is in a remarkably unhealthy state. All the streets are full of mud and putrifying filth, which gives out deadly smells. In many places there are regular heaps of filth and streams of tainted water, which also gives out horrible smells, which may certainly produce serious illnesses. The dead dogs are thrown into these streams, and produce abominable stenches, such as may be smelled near the Catholic Church and M. Kahil's house, &c. ; --rate was already shown by the registers to be twenty-three. We must her it that it was only after this fresh augmentation had been noticed that the docto le town and Dr. Eerrari began to see the sick ; they saw seven on the morning o !3rd June ; telegrams were then also sent from Damietta to Alexandria, signed b; 90 several Consuls, and in particular by Dr. Ferrari, announcing that a disease, probably cholera, had appeared at Damietta. The result was that two Medical Committees, the one sent by the Board of Health, and the other by the Maritime Sanitary and Quarantine Board, arrived on the spot on the 24th, and after inquiry, declared that it was epidemic cholera. Without being too precise as to the exact date of the outbreak of this disease, we think we may take two or three days before the 22nd June as the date ; that is, the 16th, 15th, and 14th of Shaban, which was the time that the people left after the eight days' fair. But bearing in mind the rapid rise in the mortality, we are inclined to believe that in any case the present disease broke out suddenly at Damietta. It broke out in the district of Souk-el-Ribeh, one of the most unhealthy and most densely populated in the town ; the disease was, to a certain extent, localized there for the first three days of its spread, and gradually crept out thence to the other parts of the town ; and we would here note that up till now the malady has found but few victims among the negro servants, in some of the houses forming the long frontage west of the town facing the Nile, and inhabited by the moderately well-off. Finally, the disease, behaving like a true epidemic, has spread itself along the Nile Valley, and is now supreme in many places in Lower Egypt. § IV. — Nature and Progress of the present Epidemic. The cholera epidemic, which has raged at Damietta since the 22nd June, continued to increase up to the Ist July, on which day it reached its highest point. As it thus increased, the malady showed every characteristic of an epidemic, attacking all, without distinction of age, sex, or race ; it has not, however, as yet, attacked any European ; it sometimes kills almost instantaneously ; at others, the sufferer recovers without the aid of any medical treatment, often with the least care ; but very often the disease resists all remedies. Diarrhoea is the predominating symptom with persons attacked by the cholera ; vomiting is also noticed, but it is not persistent ; the phenomenon of algidity is not very marked ; cramps also are less often to be noticed than is usual. But since the Ist July the disease decreased after remaining some days stationary ; cases thenceforward became milder, were less sudden, and yielded of tener to treatment. But recovery then became incomplete and irregular, and we have often noticed cases which passed into the typhoid state ; for some days now it has been observed that the period of recovery ends in a crisis, at which an erythmatose eruption, lasting from twenty-four to forty-eight hours, appears ; when it disappears the cure is complete. The epidemic is now rapidly diminishing ; attacks are already rare in the town, but still occur in the neighbourhood. In tracing the course pursued by the disease, it is impossible for us, and for anybody else, to know and to say in what proportion the number of attacks stands to the number of deaths per diem. The epidemic has shown, during its course, several more or less sensible undulations of augmentation and diminution ; we noticed that calm hot days increased its violence, while the mortality always fell after fresh windy weather. "With regard to the individual who died in two hours without either diarrhoea of vomiting, death took place during a convulsive fit ; and the doctor states the cause id be "eclampsis." § V. — Origin of the Epidemic. As it is now established that the disease, which arose suddenly at Damietta on or about the 22nd June, 1883, is epidemic cholera, it is of the greatest interest io try to ascertain if this cholera is the result of importation or is of local origin. When endeavouring to go into the details which are wanted for solving this problem, we do not forget the importance of this matter in relation to many grave Questions connected with the health and lives of men, and with the highest interests of their social, political, and commercial relations. We will at once state that we do not pretend to have arrived at any incontrovertible conclusion, or to have dispelled all doubt on the subject. Indeed, we showed in chapter 3 that, notwithstanding the suddenness of the spread of the epidemic, we are inclined to the belief that this suddenness is only apparent ; we also saw how difficult, nay, how impossible, it is to get at the first case tf| attack, and to be sure of the circumstances in which the disease was contracted ; 91 and that because of the bad sanitary system followed here, under which the doctor in such a town as Damietta cannot become aware of the existence of an epidemic until it has already had many victims ; for the same reason it is not possible to study the progress of the disease in its successive victims. BThus we stand confronted by two hypotheses : we will merely enumerate the tnents in favour of each, endeavouring, however, to give its due weight to each ment. ¦ (a.) Was the cholera which appeared on the 22nd June, 1883, at Damietta, rted thither from some country where it already existed in an endemic or epidemic ? BWe recently watched three consecutive outbreaks of epidemic cholera at Mecca lose namely of 1878, 1881, and 1882 — and showed well nigh material proof that malady was each time imported into Hedjaz ; we were therefore till now great izans of the theory of importation, and would not have hesitated for a moment to 5 pronounced in favour of importation in the present case also, had the facts which earched for most carefully, in order to arrive at this conclusion, appeared in any reliable. i Could one rely exclusively on the Report addressed to His Highness the Khedive is Excellency Salem Pasha in the present month, the question would be solved at , Our ex-Professor of Pathology at the School of Medicine at Cairo, and ex»ate for Egypt at the International Conference of Constantinople, has already red that the cholera was imported at Damietta, relying on the conclusions adopted le Conference in which he took part eighteeen years ago. ¦The conclusions adopted by the International Sanitary Conference of Constantij are no doubt in favour of such an assertion ; and, so far as we know, no new tific fact has been discovered to modify it. But these conclusions are already more than eighteen years old, and we are confident that in the present epidemic science will find evidence which will lead to this question being placed on a new footing. Moreover, we have a right to ask whether the conclusions of such an International Conference were really free from all political, commercial, and social considerations, and whether, as we see is the case to-day, each Delegate at the Conference was not in the habit of asking his Government for instructions on such important questions as he could not assume the responsibility of. BTo speak only of our own Egyptian Delegate at the Conference, did we not see refuse to vote with a unanimous majority on the following question proposed by Conference ?—"? — " In case a cholera epidemic should reach Egypt by way of the Red Sea, and Europe and Turkey should escape the contagion, would it not be right to interrupt temporarily all communication between Egypt and the whole Mediterranean basin ? " (adopted unanimously with the exception of Salem Bey) ; yet Dr. Salem Bey, now Salem Pasha, was at one with the majority as regards the contagious and transmissible nature of the malady. But even if we grant all authority to the conclusions drawn by the Conference, it ;ssary, in order that cholera should have been imported into Damietta, that it have been brought there by sick people or by contaminated articles, having both of them, from India during the current year, in which country cholera led hardly a month before it broke out at Damietta. Without inquiry as to the extent to which the measures of sanitary quarantine against arrivals from Bombay, Calcutta, and Java were properly enforced in Egyptian ports, we made minute and assiduous investigations in view of coming upon the track of a traveller or of a bale of merchandize coming into Damietta, no matter by what route. We even pushed our inquiries back to many months before the outbreak of the malady. The following is all the information we could collect : — On the 21st February, 1883, an Afghan, called Sultan Mohamed, son of Sardar, came to Damietta from Cairo and left for Jerusalem. M)n the 7th March a Boukariote, named Nour, son of Mohamed, arrived at etta from Port Said by the lake route, and left for Jerusalem. On the 24th March eight Afghans arrived from Cairo, and left for Jerusalem. On the 29th March an Afghan, called Hadgi Amin, son of Arsselain, came from Cairo, and left for Jerusalem. On the 24th April an Indo-Persian, called Ali, son of Hazrat-Nour, came to Damietta from Cairo, and left for Jerusalem. Bn the 20th May an Afghan, called Hadgi Mohamed, son of Darouidb, caafte to tta from Jaffa, in Syria, and left for Cairo. [1523] ft 2 92 BOn the 7th June a Boukariote, called Hadgi Nazir, son of Khoda-Wardi, came to ietta from Cairo, and left for Jerusalem. I Lastly, to complete the information, we must note that on the 24th June some ukariotes came to Damietta from Jaffa, in Syria. The six principal people among ;m arc those whose names follow : Abdel-habib, son of Mohamed ; Cherif Abdel »ur; Chiar Mohamed, son of Abdel Mound ; Gohar, son of Soltan ; Fadleldin, son Amin ; and Badaoui Woukrim. These last two arc natives of Hindustan. The chief doctor of the town of Damietta, Ali Effendi Ghibril, assured me that these strangers were at least twenty in number with their wives and children, and that they came to .Damietta on Thursday, the 21st, whilst the passport office entered them about the 21st. But in verifying the exact date of their arrival at Damietta by sea at the quarantine office it appears certain that they did indeed arrive on the 24th June, and that the number of travellers was twenty-one ; but there were but six strangers among them, namely, the Boukariotos and natives of Hindustan, whose names we gave above ; the rest were Jews, including the llabbi, Achil-ben- Benjamin, and his son, and native Egyptians. But Damietta can be approached otherwise than by sea. Merchandize and strangers can come thither by way of the lake. It is so close to Port Said, and its daily relations with that port are so continuous, that it would be possible for foreign merchants, or even for simple workmen of Port Said from among those who work on board the ships coming from India, to have entered Damietta, and to have brought the disease with them. It has been said that during the Fair of Sheikh Abou-el-Maati, which brought som 15,000 people to Damietta, two merchants were present in the town who had just com from Bombay. This information was given to us in a note from Dr. A: douin Bey, wh in his turn had it from an English doctor, who was very respectable and worth of belief. It is easy to understand with what zeal we sought information from th merchants, Notables of the town; the following is what the Notable Said-el-Loz thinks he is able to be positive about : " During the fair no Indian merchant o tradesman appears to have been present, neither anybody selling Indian goods certainly a stranger was seen, with a turban like a Dervish's, and tolerably we dressed, but he spoke to many people of the town, and told everybody that he hac come from Cairo, where he had lived for seven years." Lastly, Dr. Flood, doctor at the Port Said hospital, who, like ourselves, is a great partizan of the theory of the importation of the disease now prevailing as an epidemic at Damietta, had, as we also had, for a moment thought that he had found the key to the enigma, wrote a Report to his Excellency Salem Pasha on the sth July, which Report has been communicated to the whole of the local press, and from which we quote the following passage :—: — "On the 18th June a stoker called Mohamed Khalifa, a native of Upper Egypt, landed at Port Said from the English steamer 'Timor,' from Bombay for Naples and Genoa ; he left immediately for Damietta. I inclose to your Excellency the answer, received this day from the Governor of Damietta, to two telegrams sent to him at my request about Mohamed Khalifa by his Excellency the Governor- General of the Canal. Although they are not sufficiently satisfactory to explain tht, spread of a cholera epidemic at Damietta, they are enough to warrant the fact of the importation of the malady by Mohamed Khalifa being admitted. 11 Perhaps cholera-like cases had taken place on board the ' Timor ' after she left Bombay, and consequently Khalifa would, on reaching Port Said, have been in the incubation period of the disease ; is it not equally possible that this man may have been seized with choleraic diarrhoea when he got to Damietta ?" Dr. Flood's Report came to our knowledge on the 9th July in the newspapers and admitting with its author the possibility that cases of cholera may have taken place on board the " Timor," that Khalifa may have found himself in the incubation period of the malady when he got to Port Said, and that it was likewise possible tha he may have been seized with choleraic diarrhoea on reaching Damietta, we were abou to applaud the efforts made by our colleague of Port Said, and cry victory with him We therefore hastened to make searching inquiry into the facts of Mohamec Khalifa's case and into his movements, leaving to others the duty of examining the circumstances in which the "Timor's " sanitary inspection and bill of health had been managed in all the Egyptian ports which she passed between Suez and Port Said, as well as her treatment on reaching Naples and Genoa. (See Annex No. 1.) With this view the following persons met at the Damietta Health and Sanitary Office on the 9th July : Dr. Ahmad Nadim Effendi, Sanitary Inspector of the town ; 93 Eendi Ghibril, chief doctor of the place ; Ahmet Bey Chaffey, delegate of the m Quarantine Board ; Spiridion Cossery, clerk at the Damietta Quarantine and Spiridion Passiour, Notable of the town; they called Mohamed Khalifa, personally appeared before them and made the following declaration : — " He is from the Moudirieh of Kene (Upper Egypt), is between 32 and 34 yeai of age, left his own country seven years ago ; he has been long employed at Por Said in the service of the Canal Company as a stoker, and hired himself two month ago as a stoker on board an English ship, of which he does not know the name, am which left for Bombay. The ship stayed there three weeks, during which tim Mohamed Khalifa was not aware of the existence of any disease at Bombay. Th ship then left Bombay, in good sanitary condition, laden with cotton and rice ; thei were no passengers besides the crew, which was in good health all the time, am during the voyage of twenty-one days from Bombay to Port Said no one was i] When he reached Port Said and his engagement was finished, he left the ship am went to his house, where he stayed four days. Then, having had a quarrel with cavalry soldier of the Government he was arrested and put in prison for three day at the end of which he Avas exiled from the town, by the order of the Governor, as bad character, and he then left for Damietta by boat, vi& the lake, and arrived ther after a voyage of twenty hours, on the morning of Sunday, the 24th June, 1883. O reaching the town he went often to the cafe called f Salem-el-Sandoubi ;' he the got drunk and was put in prison for some hours. He remained at Damietta till th Ist July, 18 S3, in good health. Towards the end of the Ist July he was seized wit vomiting and diarrhoea, which passed off on the following day without medicine." The doctors present examined Mohamed Khalifa after this declaration, and found that, although still convalescent, the state of his health was satisfactory. As it was shown by the declaration of Mohamed Khalifa himself that the date of his departure from Port Said and his arrival at Damietta did not correspond with the 18th June as Dr. Elood affirms, the following telegram was dispatched the same day to Dr. Pestrini at Port Said :—: — X Ascertain from Governor Port Said what day Mohamed Khalifa was exiled, Lswer quickly. (Signed) "Chaffey Bey." And Pestrini answered by the following telegram :—: — " Mohamed Khalifa was exiled from Port Said on Shaban 18, equals the 23rd (Signed) " Pestrini." _; ¦It will be seen at once that Dr. Elood mistook the 18th June for 18 Shaban. (See 3X NO. 1.) I Seeing these facts, we now find it positively impossible to pronounce in favour of mportation of the cholera of this year into Damietta, and we are therefore obliged nsider the cosmic, telluric, and social conditions, ordinarily or accidentally existing, bich the cholera developed itself there as an epidemic. ¦(&.) Could the cholera which appeared at Damietta on the 22nd June, 1883, have oped spontaneously ? B?rom the narrative which we have given in chapters 1 and 2 of this Report, it ,rs that, in addition to the lamentable permanent sanitary conditions which make etta the type of filthy cities, there were : — KThe mouth of a river dried up by a prolonged drought, which laid bare its and a part of its bed, the mud of which had fermented under the action of a ul sun. 2. This river carried down for more than a year (and collected them in the angle which the river forms at Damietta) thousands of carcases of animals which stranded on its slimy banks, where they putrefied in the damp and heat. y). The river receives at the same place the outflow of the drains, animal and able detritus, and filth of every kind which the current cannot carry away, as topped by the waves of the sea. E4. The miasma produced by all this putrefying matter joins the vegetable uvium coming from the marshes, from the soil which is full of organic matter, and m the rice-fields which surround the town. 5. The water of this river was used by the greater part of the inhabitants and by more than 15,000 people from different parts of Egypt who filled the town for eight consecutive days on the occasion of the fair of Sheikh Abou-el-Maati. This water 94 6. During these eight days that these people were crowded into the town, there X veritable orgies at which nothing was eaten hut the flesh of animals which had of typhus, and of which the hides now fill the large warehouses in the town and 7. The epidemic broke out immediately on the conclusion of the fair. 8. The 19th, 20th, and 21st days of June were marked by a sudden rise in the temperature. 9. The disease appeared principally in the most unhealthy and most populous parts of the town, which are inhabited by poor people who use only the water of the river and of the halig. 10. The disease remained localized for a long time at Damietta before it spread itself, and the spread always happened in places situated on the banks of the river, and by means of sick who had emigrated from Damietta ; witness the towns of Port Said, Alexandria, Ismailia, Suez, &c, 11. The rise and fall of the epidemic here is insignificant compared with that of the epidemics of 1865 and 1866. 12. The notable diminution in the number of seizures observed after Mr. Goodall had buried nearly 1,000 carcases and fragments of animals which choked up the river. 13. The mathematical and almost miraculous coincidence of the fall in the mortality with the arrival here of the fresh water of the rising Nile. 14. Lastly, the epidemic has now almost died out in Damietta after the execution of a part of the measures which had been ordered. Do these facts prove the second hypothesis conclusively, in the sense that they show that the same cosmic and hydrotelluric causes which are present at the beginning of an outbreak on the delta and banks of the Ganges were this year present on the delta and banks of the Nile ? We admit that we do not possess the necessary authority to pronounce on this point, and we submit it in the shape of observations for the future judgment of science. "We must, lastly, quote here, though without drawing any practical conclusions from it, an official document relating to the subject under consideration. It is the despatch sent by his Excellency the Governor of Damietta to the Maiiah on the 26th June (translated from the Arabic) :—: — " The investigations made as to the causes of the outbreak of the disease at Damietta have shown that it was the result of the crowding together of people at the mid-Shaban fair, who partook incontinently of water-melons, cucumber, and fisikhs ; but, thank God ! there is now an improvement. § VI. — Measures taken with regard to the present Epidemic. It has been noticed in the preceding chapter that the measures taken to crush the epidemic at its first focus were in part useless. On this head it is necessary to give some explanatory details. "We readily acknowledge, and that without any intention of flattering, that the fault lay neither with the orders drawn up and given each day by the Ministry and the Sanitary Boards, nor with the requests made by the medical body here to the executive authorities. In the same impartial spirit which has hitherto guided us, we are now about to enumerate the measures which were carried out, and those which were not, or which were executed imperfectly or after delay :—: — 1. We must now declare that the sanitary cordons formed round Damietta did not work satisfactorily from the time they were established to that when they were withdrawn. 2. The most important measure, which consisted in clearing the populous and low quarters which were most infected by the disease, was not carried out, in spite of the existence of everything necessary to carry it out. 3. The most rational measure, which consisted in filling up the latrines of the mosques and public baths with earth and lime, and then nailing, or even walling them up, was only begun for show, and even this show was kept for a few days only. 4i. No huts or cabins were burnt, pulled down, or disinfected. 5, It would be an error to suppose that it was possible after the tot to \)Um th* goods of patients who died of cholera* 95 6. No house was whitewashed. 17. In view of the difficulty experienced in having the streets regularly swept watered, it was thought well to cover the soil of the town with a thick layer ad ; this measure, which had an excellent effect, was only completed within the ew days. 83. The burial of the dead in cemeteries in the midst of the dwellings never i ; and neither there nor elsewhere did any one venture to throw chloride of lime c corpses. 9. As regards the cementing ordered in these circumstances in order to close up hermetically the outside of the tombs, it is credibly affirmed by officials that the persons whose duty it was to carry out this measure preferred to sell the plaster and lime. Besides, what would be the use of cementing a vault which has to be opened as many times in the day as there are deaths in a family ? 10. There were only four doctors sent here, and they were scarcely able to get through the hard task that was before them, although they gave proof of devotion, zeal, ability, and courage by working day and night, and although some of them would not stop working when they fell ill. We hold it a duty to express now, in the name of the public, our sincere congratulations to Drs. Ahmed Nadim Effendi, Mohamed Amin Effendi, Kassim Mohamed Effendi, and Hassan Hassan Effendi. We can say as much of the zeal and devotion of the only druggist who was sent here, M. Ahmed Effendi Hamdi, who was able both by night and day to meet all requirements. 11. We must also state that not only was there an insufficient supplyof medicines and disinfectants sent here at first (80 kilog. of chloride of lime), but also that the second supply stayed outside the cordon three days before it could be brought into the town. We regret to be obliged, in the name of truth and for the good of the country, to disclose facts which we should have been happy not to have had to state. We finish our Report by a sincere wish that the near future will profit by the experience of the past, in order to avoid fresh misfortunes, and that before reforming its social and political institutions, Egypt will reform its sanitary institutions, which are the basis of all. (Signed) Ahmet Chaffey Bet, Dr. Salvatore Ferrari, Dr. Annex No. 1. (Translation from the Arabic.) Td his Excellency the President of the Maritime Sanitary and Quarantine Board at Alexandria. I have the honour to inform you that from the investigations which have been made about Mohamed Khalifa, stoker, it appears that he left Port Said for Bombay on the 25th April, 1883, on an English ship called the " Timor," which left Bombay for Port Said on the 19th day of June, 1883. The said stoker disembarked at Port Said and went to his house, thence he went to Damietta on the 23rd June, 1883, and has not returned. The head stoker declares that the said Mohamed Khalifa did not go to Damietta after his last voyage. (Signed) The Governor of Port Said. Annex No. 2. The Undersigned, Ibrahim Moustapha, chemical expert, nominated by his Excellency Hassan Pasha Mahmoud, President of the Maritime Sanitary and Quarantine Board, to make a chemical and microscopic analysis of the water of Damietta, reports as follows : — bThe water was contained in six glass bottles placed in a tin box ; two of the es were broken, and the four others were sealed with red wax, the impression of eal was not legible. I opened the four bottles and found, that the water was not clear, and that it turned red. litmus papfcr blue, 96 I proceeded to analyze the water in the following manner : — 1. I added to some water in a test tube a few drops of azotate of silver, containing an excess of azotic acid. The water did not become turbid. 2. I added a few drops of a solution of chloride of barium to some water in a test tube. The water did not become turbid. 3. I added a few drops of acetate of lead to some water in a test tube. There was neither turbidity nor precipitate. 4. I added a little solution of nitro-prussiate of sodium to some water. There was no violet colour shown. 5. I added a few drops of solution of oxalate of ammonia to soma water. No precipitate was produced. 6. I added to some water a solution of chloride of ammonium, I filtered the solution, and mixed the filtered liquid with a solution of phosphate of sodium and a little ammonia. No precipitate was formed. 7. I added some of Bohlig's liquid to some water. A slight white precipitate was formed. 8. I added to some water a little of Nessler's reagent. A slight reddish brown precipitate was formed. 9. I boiled some water in a glass flask with some drops of solution of caustic potash, and I placed near the opening of the flask a rod wetted with hydrochloric acid. There was a white cloud round the rod. 10. I boiled some water in a glass flask, and I placed near the opening of the flask a piece of paper which had been previously dipped in a solution of fuchsine treated with sulphuric acid. The paper which had been white became red. 11. I placed 100 cubic centim. of water in a porcelain capsule, and added a few drops of chloride of gold, so that the water became of a yellowish tint, and I then boiled the liquid. There was a black deposit, and the water became violet. 12. I determined the hardness of the water by the hydrotimetric method, and I found that the hydrotimetric degree of the water was 17. 13. I evaporated and dried 100 cubic centim. of water in a weighed capsule of platinum ; I completed the desiccation in a Wasing drying apparatus at a temperature of 120 degrees. When I placed the capsule in the scales, the weight was found to be o*o4B grammes. 14. I calcined the evaporation residue obtained in operation 13, I allowed the capsule to cool, and then I added a solution of carbonate of ammonia. I evaporated it until completely dry, and I placed the capsule in the balance. The weight was 0*027 grammes. 15. I added, drop by drop, to 100 cubic centim. of water nearly boiling, a solution of permanganate of potassium, containing 1 gramme of the salt to the litre, so that 1 cubic centim. of the solution would represent 5 millig. of organic matter— -4* c.c. 3 were needed to produce a red colour. 16. I placed on the microscope stage a drop of the turbid water deposited at the bottom of the bottles, and after having placed a covering glass over it I examined it through the microscope (magnifying it 500 diameters), and I observed : (1) fragments of vegetable matter and chlorophyl ; (2) infusoriae, principally of the order Vibrio. Signification of the Results obtained, and Conclusion. The result of the experiments is — Of experiments 1, 2, 3, 4, 5, and 6, that the water submitted to examination contains no appreciable traces of chlorides, sulphates, alkaline sulphides, or soluble salt of magnesia. Of experiments 7, 8, and 9, that the water contains ammonia (free or in combination) in appreciable quantities. Of experiment 10, that the ammonia is at least partly free. Of experiment 11, that the water contains a considerable quantity of organic matter. Of experiment 12, that the hardness of the water is normal. Of experiment 13, that the solids contained in the water are in the proportion of O*O4S gr. to 100 cubic centim., or o*4Bo gr. to the litre. Of experiment 14, that the proportion of organic matter contained in the water is o*o2l in 100 cubic centim., and that of fixed matter 0 027 gr., which gives for a litre of water : organic matter, o*2lo gr. ; fixed matter, 0*270 gr. Of experiment 15, that the proportion of organic matter for 100 cubic centim. i» 97 gr., which gives for one litre 0*215 gr., a result identical with that 01 experiment 16, that the water contains putrefying matter besides the infusorial s, which are only observed in infusions. In fine : 1. The proportion of mineral substances contained in the water analyzed is normal, as it is only 0*270 gr. to the litre ; drinkable water may contain up to o*soo gr. to the litre. 2. The water contains a great quantity of organic matter which is probably of animal origin, seeing that there is ammonia in the water. 3. It contains putrescent matter. 4. It contains inf usorise, especially those of the order Vibrio, and fragments of vegetable substances. Prom what precedes, and seeing that one of the essential conditions for water to be fit to drink is that "it should be free from organic matter capable of putrefying," I think that I may fairly conclude that the water submitted to examination is unfit for public use. (Signed) Ibrahim Mtjstapha. Alexandria, July 21, 1883. P.S. — The microscopic examination mentioned in this Report was made in the presence of Dr. Abbate Pasha. I. M. Annex No. 3. Sir, Suez, July VI, 1883. In reply to your letter of the 12th instant, I have the honour to communicate] to you the following information : — The English steamer "Timor," commanded by Mr. John Anderson, arrived a this port from Bombay on the 17th June last about 6 a.m., after a passage of seventee days ; she had a crew of thirty men and a mixed cargo ; no business was transacte( by the ship in this port. As soon as this steamer arrived I went on board as usual t transact the customary quarantine business ; I asked the master for the bills of healt which had been given him by the sanitary authorities where he had last touched, anc I found the bills clean and in order, without any note. Further, I asked the maste if there had been any illness or any deaths on board during the voyage, and whethe he had spoken, &c, any other ship at sea. On his replying in the negative, I aske< the master to bring all the officers and crew before me, and I found them all in perfect health. When these formalities had been gone through I sent the steamer t Moses' Wells for twenty-four hours of quarantine of observation, in accordance wit the orders received from the Maritime Sanitary aad Quarantine Board for vessels comin from Bombay. The next morning at the same hour, when the above-mentioned time of observation had expired, the ship returned to this anchorage, and I went on board to order the ship to be disinfected ; I then subjected all those on board to a strict medteat examination, confronting them with the statements in the ship's papers, and, finding them all in perfect health, I admitted the above-mentioned steamer to free pratique, after repeating my questions to the master, who gave favourable answers, and signed the bill. The same day at noon the steamer " Timor " entered the Canal, and it could not, therefore, have reached Port Said on the 18th June, as Dr. Mood states in his Report to the Public Health and Sanitary Board, of which your Excellency sent me a copy ; but the " Timor " reached Port Said on the 19th June at 4*30 p.m., as shown by the note sent to me at my request by the Suez Canal Company. Having thus shown the errors in the dates given by Dr. Plood in the information he furnished to the Board relative to the arrival of the above-mentioned steamer at Port Said, I take the opportunity of giving your Excellency some explanations in regard to the phrase of which Dr. Flood makes use in his Report, vi&, '* Perhaps there were cases of cholera on board the • Timor ' after she left Bombay." On this subject I hasten to inform your Excellency that when I gave pratique to the steamer already mentioned, I not only verified the number of the crew by the declaration of the master, but without trusting to that I asked, as has always been done, for all the ship's papers, amongst which I found the ship's articles, and they agreed with the declaration made. r15231r 15231 O COMMERCIAL. No. 34 (1883). Correspondence respecting the Cholera Epidemic in Egypt: 1883. Presented to both Houses of Parliament by Command of Her Majesty. 1883. LONDON :